title: [Urinary, infectious and digestive adverse events related to benign hysterectomy and the associated surgery on the Fallopian tube: Guidelines].
abstract: OBJECTIVE
  To provide clinical practice guidelines from the French College of Obstetrics and Gynecology (CNGOF) based on the best evidence available, concerning the urinary, infectious and digestive adverse events related to benign hysterectomy and the associated surgery including opportunistic salpingectomy and adnexectomy.
  
  
  METHODS
  Review of literature using following keywords: benign hysterectomy; urinary injury; bladder injury; ureteral injury; vesicovaginal fistula; infection; bowel injury; salpingectomy.
  
  
  RESULTS
  Urinary catheter should be removed before 24h following uncomplicated hysterectomy (grade B). In case of urinary catheter during hysterectomy, immediate postoperative removal is possible (grade C). No hemostasis technics can be recommended to avoid urinary injury (grade C). There is not any evidence to recommend to perform a window in the broad ligament or an ureterolysis, to put ureteral stent or a uterine manipulator in order to avoid ureteral injury. An antibiotic prophylaxis by a cephalosporin is always recommended (grade B). Mechanical bowel preparation before hysterectomy is not recommended (grade B). If there is no ovarian cyst/disease and no familial or personal history of ovarian/breast cancer, ovarian conservation is recommended in premenopausal women (grade B). In postmenopausal women, informed consent and surgical approach should be taken in account to perform a salpingo-oophorectomy. Since the association salpingectomy and hysterectomy is not assessed in the prevention of ovarian cancer, systematic bilateral salpingectomy is not recommended (expert consensus).
  
  
  CONCLUSIONS
  Practical application of these guidelines should decrease the prevalence of visceral complications associated with benign hysterectomy.
authors.affiliation: Département de gynécologie-obstétrique, hôpital Femme-Mère-Enfant, HFME, hospices civils de Lyon, 69002 Lyon, France; Université Claude-Bernard Lyon 1, EMR 3738, 69100 Villeurbanne, France. Electronic address: chenegautier@yahoo.fr.
authors.forename: G
authors.initials: G
authors.lastname: Chêne
authors.affiliation: Département de gynécologie-obstétrique, hôpital Femme-Mère-Enfant, HFME, hospices civils de Lyon, 69002 Lyon, France.
authors.forename: G
authors.initials: G
authors.lastname: Lamblin
authors.affiliation: Département de gynécologie-obstétrique, hôpital La Conception, Aix-Marseille université, 13005 Marseille, France.
authors.forename: M
authors.initials: M
authors.lastname: Marcelli
authors.affiliation: Département de gynécologie-obstétrique, hôpital Mère-Enfant, CHU de Limoges, avenue Larrey, 87000 Limoges, France.
authors.forename: S
authors.initials: S
authors.lastname: Huet
authors.affiliation: Département de gynécologie-obstétrique, hôpital Mère-Enfant, CHU de Limoges, avenue Larrey, 87000 Limoges, France.
authors.forename: T
authors.initials: T
authors.lastname: Gauthier
mesh_terms: D004066:Digestive System Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D005187:Fallopian Tubes / Q000601:surgery*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods / Q000592:standards*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D060737:Reproductive Tract Infections / Q000453:epidemiology / Q000209:etiology*; D058994:Salpingectomy / Q000009:adverse effects / Q000379:methods / Q000592:standards; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D014555:Urination Disorders / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control
keywords: Benign hysterectomy; Bladder injury; Bowel injury; Fistule vésicovaginale; Hystérectomie bénigne; Infection; Plaies intestinales; Plaies urinaires; Plaies urétérales; Plaies vésicales; Salpingectomie; Salpingectomy; Ureteral injury; Urinary injury; Vesicovaginal fistula