title: Urinary tract injury in laparoscopic-assisted vaginal hysterectomy.
abstract: OBJECTIVE
  To evaluate the incidence and characteristics of urinary tract injury after laparoscopic-assisted vaginal hysterectomy (LAVH).
  
  
  METHODS
  A retrospective study that evaluated all cases of urinary tract injury at the time of LAVH in an 11-year period. Parameters including surgical indication, site of injury, time of diagnosis, method of treatment, and long-term follow-up were analyzed. (Canadian Task Force classification II-2).
  
  
  METHODS
  Tertiary care university hospital.
  
  
  METHODS
  A total of 38 urinary tract injuries were found in 7725 LAVH.
  
  
  METHODS
  LAVH and repair of urinary tract injuries with transvaginal or transabdominal approach.
  
  
  RESULTS
  The incidence of urinary tract injury after LAVH was 4.9/1000 procedures: 3.9/1000 for urinary bladder injury and 1.0/1000 for ureteral injury. Prior cesarean section was the most common risk factor for bladder injuries. Ninety-six percent (29/30) of urinary bladder injuries were detected and treated during surgery. Half (4/8, 50%) of the ureteral injuries were identified during surgery. Of the 38 complications, 28 (75.7%) occurred in surgery.
  
  
  CONCLUSIONS
  Most urinary tract injuries in LAVH were identified during surgery and are associated with the surgeon's experience. Bladder injury can be repaired either transvaginally or abdominally; ureteral injury can be repaired abdominally.
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung University College of Medicine, Kwei-Shan, Tao-Yuan, Taiwan. yks@cgmh.org.tw
authors.forename: Yung-Kuei
authors.initials: YK
authors.lastname: Soong
authors.forename: Hsing-Tse
authors.initials: HT
authors.lastname: Yu
authors.forename: Chin-Jung
authors.initials: CJ
authors.lastname: Wang
authors.forename: Chyi-Long
authors.initials: CL
authors.lastname: Lee
authors.forename: Hong-Yuan
authors.initials: HY
authors.lastname: Huang
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D002681:China; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects*; D010535:Laparoscopy / Q000009:adverse effects*; D019300:Medical Errors / Q000009:adverse effects* / Q000706:statistics & numerical data; D008875:Middle Aged; D012189:Retrospective Studies; D014513:Ureter / Q000293:injuries*; D001743:Urinary Bladder / Q000293:injuries*