title: Urologic complications of laparoscopic radical hysterectomy and lymphadenectomy.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the intra- and postoperative urologic complications and management in patients with cervical or endometrial cancer treated with laparoscopic radical hysterectomy and lymphadenectomy.
  
  
  METHODS
  We retrospectively reviewed the medical records of 146 patients with cervical or endometrial cancer who underwent total laparoscopic radical hysterectomy with lymphadenectomy between August 2002 and April 2011. The intra- and postoperative urologic complications were analyzed.
  
  
  RESULTS
  Double ureteral stents were inserted prophylactically in 13 patients (8.9 %), 2 of whom had postoperative urologic complications. Nine patients (6.2 %) had postoperative urologic complications. Of four patients with ureterovaginal fistulas, two were treated conservatively with cystoscopic placement of ureteral stents and two underwent ureteroneocystostomies. Vesicovaginal fistulas occurred in two patients, both of whom underwent vesicovaginal fistula repairs. One patient noted to have a bladder injury intraoperatively had a laparoscopic repair, and one patient noted to have a ureteral injury postoperatively was treated conservatively with cystoscopic placement of ureteral stents.
  
  
  CONCLUSIONS
  Iatrogenic lower urinary tract injuries during laparoscopic radical hysterectomy are relatively common complications. Intraoperative prophylactic ureteral stent insertion and the early detection of urologic complications postoperatively is advised for patients who undergo laparoscopic radical hysterectomies.
authors.affiliation: Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, 323 Illsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Korea.
authors.forename: Jong Ha
authors.initials: JH
authors.lastname: Hwang
authors.forename: Myong Cheol
authors.initials: MC
authors.lastname: Lim
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Joung
authors.forename: Sang-Soo
authors.initials: SS
authors.lastname: Seo
authors.forename: Sokbom
authors.initials: S
authors.lastname: Kang
authors.forename: Ho Kyung
authors.initials: HK
authors.lastname: Seo
authors.forename: Jinsoo
authors.initials: J
authors.lastname: Chung
authors.forename: Sang-Yoon
authors.initials: SY
authors.lastname: Park
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D016889:Endometrial Neoplasms / Q000601:surgery; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D007049:Iatrogenic Disease / Q000453:epidemiology*; D015994:Incidence; D059411:Lower Urinary Tract Symptoms / Q000453:epidemiology* / Q000209:etiology* / Q000601:surgery; D008197:Lymph Node Excision / Q000009:adverse effects*; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D014570:Urologic Diseases / Q000453:epidemiology* / Q000209:etiology* / Q000601:surgery; D002583:Uterine Cervical Neoplasms / Q000601:surgery