Mild hydronephrosis after uncomplicated hysterectomy.
OBJECTIVE
To explore differences in the incidence of hydronephrosis following different hysterectomy methods for benign gynecological disease.


METHODS
Retrospective chart review of ultrasound findings on all patients undergoing simple hysterectomy for benign gynecological pathology between July 2004 and September 2008. Elective renal ultrasonography was performed pre-operatively and within 3 days after hysterectomy as part of the routine follow-up in our hospital.


RESULTS
Of 385 eligible patients, six were excluded because of pre-existing hydronephrosis or suspected intra-operative ureteral injury. In the resulting group of 379 patients, abdominal (33.3%), vaginal (11.8%) or laparoscopic hysterectomy (54.9%) was performed. The last group included total laparoscopic hysterectomy (TLH, 20.3%), laparoscopic supracervical hysterectomy (LASH, 19.3%), and laparoscopically assisted vaginal hysterectomy (LAVH, 15.3%). Overall, 56.7% of patients showed mild hydronephrosis (5-15 mm pelvicalyceal dilatation) after surgery. Mostly, it occurred unilaterally. The incidence varied according to the type of procedure, the highest being documented following vaginal hysterectomy (64.4%) and the lowest after LASH (46.6%), but this did not reach statistical significance.


CONCLUSIONS
Mild hydronephrosis is a frequent finding after uncomplicated hysterectomy for benign pathology in otherwise asymptomatic patients. Although not statistically significant, there may be variability of mild hydronephrosis depending on the hysterectomy method.
Department of Obstetrics and Gynecology, Erlangen University Hospital, University of Erlangen-Nuremberg, Erlangen, Germany. thomas.hildebrandt@uk-erlangen.de
T
T
Hildebrandt
A
A
Mueller
F C
FC
Thiel
L
L
Häberle
S
S
Cupisti
M W
MW
Beckmann
S P
SP
Renner
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005831:Genital Diseases, Female / Q000601:surgery; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology*; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D007045:Hysterectomy, Vaginal / Q000009:adverse effects; D007668:Kidney / Q000000981:diagnostic imaging; D010535:Laparoscopy / Q000009:adverse effects; D008875:Middle Aged; D012189:Retrospective Studies; D014463:Ultrasonography