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Operative injuries during vaginal hysterectomy
P Mathevet1, P Valencia, C Cousin
1Department of Gynecology, Hopital E. Herriot, Pavillon L., 69437 Lyon Cedex 03, France.
Summary
Urinary tract injuries occurred in 1.7% and intestinal injuries in 0.5% of vaginal hysterectomies. Most injuries were bladder lacerations, all repaired during surgery with minimal long-term effects.
Area of Science:
- Gynecologic surgery
- Surgical complications
- Urologic and gastrointestinal tract injuries
Background:
- Vaginal hysterectomy is a common procedure for benign conditions.
- Understanding operative injury rates and outcomes is crucial for patient safety.
Purpose of the Study:
- To determine the incidence, characteristics, and consequences of urinary and intestinal tract injuries during vaginal hysterectomy.
- To evaluate the management and outcomes of these injuries.
Main Methods:
- Retrospective analysis of 3076 vaginal hysterectomies performed between 1970 and 1996.
- Review of operative records to identify and characterize urinary and intestinal tract injuries.
Main Results:
- The incidence of urinary tract injuries was 1.7% (54 bladder lacerations, 1 ureteral lesion).
- The incidence of intestinal tract injuries was 0.5% (16 rectal lacerations).
- All injuries were recognized and repaired during the primary operation, with most healing without sequelae; 4 cases of vesico-vaginal fistula occurred.
Conclusions:
- Operative injuries during vaginal hysterectomy are infrequent.
- These injuries are typically identified and managed effectively during the initial surgery, leading to good outcomes.