The risk of ureteric injury associated with hysterectomy: a 10-year retrospective cohort study.
OBJECTIVE
To evaluate the rates of ureteric injury among women undergoing hysterectomy.


METHODS
Retrospective cohort.


METHODS
English National Health Service hospitals.


METHODS
Women undergoing hysterectomy in 2001-2010.


METHODS
Unadjusted rates of ureteric injury, within 1 year of hysterectomy, calculated by indication and type of procedure. Multivariable logistic regression used to assess the risk of ureteric injury with year of surgery.


METHODS
Ureteric injury within a year of the hysterectomy.


RESULTS
In 2001-2010, 377 073 women underwent hysterectomy, of whom 1792 (0.5%) experienced a ureteric injury. In both benign and malignant groups the rate of injury was higher in 2006-2010 than 2001-2005. After 2006, ureteric injuries were most common for abdominal radical hysterectomy for uterine cancer (10.7%; 95% CI 7.3-15.1%). The proportion of women having a ureteric injury was similar for ovarian and cervical cancer (1.9-4.0% depending on type of procedure). For benign conditions, the rate of injury tended to be lower, typically <1%. Women with endometriosis had the highest risk among this group (1.7% following total abdominal hysterectomy; 95% CI 1.4-2.0%).


CONCLUSIONS
The risk of ureteric injury within 1 year of hysterectomy varied by type of hysterectomy for benign and malignant conditions. The rates of injury have increased between 2001 and 2010.


CONCLUSIONS
Ten-year study shows ureteric injury rates have increased.
Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.|Lindsay Stewart Centre for Audit and Clinical Informatics, Royal College of Obstetricians and Gynaecologists, London, UK.
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A
Kiran
Directorate of Women's Services, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
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P
Hilton
Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.|Lindsay Stewart Centre for Audit and Clinical Informatics, Royal College of Obstetricians and Gynaecologists, London, UK.
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Cromwell
D000328:Adult; D017677:Age Distribution; D000368:Aged; D004715:Endometriosis / Q000453:epidemiology / Q000601:surgery; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D007431:Intraoperative Complications / Q000453:epidemiology / Q000209:etiology; D010535:Laparoscopy / Q000009:adverse effects / Q000706:statistics & numerical data; D007889:Leiomyoma / Q000453:epidemiology / Q000601:surgery; D008599:Menstruation Disturbances / Q000453:epidemiology / Q000601:surgery; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000601:surgery; D056887:Pelvic Organ Prolapse / Q000453:epidemiology / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D014513:Ureter / Q000293:injuries*; D014594:Uterine Neoplasms / Q000453:epidemiology / Q000601:surgery
Hospital Episode Statistics; hysterectomy; surgical injuries; ureteric injury; ureteric stricture; ureterovaginal fistula