Lower urinary tract injury in women in the United States, 1979-2006.
OBJECTIVE
We sought to determine age-adjusted rates (AARs) of lower urinary tract injury and incidence in selected inpatient gynecologic and obstetric procedures.


METHODS
We utilized the National Hospital Discharge Survey, 1979-2006. AARs of nonobstetric bladder and ureteral injuries and incidence of lower urinary tract injury for various hysterectomy types and deliveries were calculated for women>18 years old.


RESULTS
Overall AARs of ureteral injury decreased from 0.06-0.03 per 1000 women (1979-2006). AARs of inpatient gynecologic procedures decreased from 24.9-11.8 per 1000 women (1979-2006). By hysterectomy type, bladder injury was highest in laparoscopic-assisted vaginal hysterectomy (VH) (13.8 per 1000) and VH (13.1 per 1000). Ureteral injury recognized during hysterectomy was most common with radical hysterectomy (7.7 per 1000) and least common with laparoscopic-assisted VH (0 per 1000).


CONCLUSIONS
Ureteral injuries at time of inpatient surgical procedures have decreased from 1979-2006. This corresponds with a sharp decrease in inpatient gynecologic procedures.
Frankman
Elizabeth A
EA
Division of Urogynecology, Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Women's Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Wang
Li
L
Bunker
Clareann H
CH
Lowder
Jerry L
JL
D000293:Adolescent; D000328:Adult; D003558:Cystoscopy; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000706:statistics & numerical data; D015994:Incidence; D007889:Leiomyoma / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D014481:United States; D014513:Ureter / Q000293:injuries*; D014521:Urethra / Q000293:injuries*; D001743:Urinary Bladder / Q000293:injuries*; D014549:Urinary Incontinence / Q000453:epidemiology; D014594:Uterine Neoplasms / Q000453:epidemiology; D014596:Uterine Prolapse / Q000453:epidemiology; D055815:Young Adult