title: Ureteral catheter placement for prevention of ureteral injury during laparoscopic hysterectomy.
abstract: OBJECTIVE
  Ureteral injury is among the most devastating complications of gynecologic surgery. Estimated incidence of ureteral injury during laparoscopic hysterectomy is 2.6-35 times (0.2-6.0%) that in abdominal hysterectomy. We investigated preoperative ureteral catheter (UC) placement as a way to prevent ureteral injury in laparoscopic hysterectomy.
  
  
  METHODS
  Clinical records of 94 women who underwent laparoscopic hysterectomy between February 2006 and January 2007 in Yazaki Hospital, Kanagawa, Japan, were reviewed retrospectively. Thirty-four patients between February and June 2006 underwent the surgery without ureteral catheterization and 60 patients between July 2006 and January 2007 underwent surgery with ureteral catheterization. Clinical outcomes were statistically compared between the two groups.
  
  
  RESULTS
  The average time required for catheter insertion was 9.35 min. The ureter in which the catheter was placed was visualized clearly. In one patient, whose left ureter was deviated by a massive myoma, catheter insertion was not possible. No complications arose from catheter placement except for minor complaints including low back pain, urinary discomfort, and transient hematuria. While one injury occurred in a patient without ureteral catheterization (1/34), no ureteral injury occurred in any patient with ureteral catheterization (0/60). Operative time, total blood loss, and hospital stay were not significantly different between the two groups.
  
  
  CONCLUSIONS
  UC placement is simple, helping to prevent ureteral injury during laparoscopic hysterectomy and enhancing safety of this procedure.
authors.affiliation: Department of Obstetrics and Gynecology, Yazaki Hospital, Kanagawa, Japan. yudai_hello@yahoo.co.jp
authors.forename: Yudai
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Hironori
authors.initials: H
authors.lastname: Asada
authors.forename: Naoaki
authors.initials: N
authors.lastname: Kuji
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Yoshimura
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D007564:Japan / Q000453:epidemiology; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods; D008499:Medical Records; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D014513:Ureter / Q000293:injuries*; D014546:Urinary Catheterization / Q000009:adverse effects* / Q000379:methods