Pre-operative ureteric catherisation for major endoscopic gynaecological surgery
Wei How Lim1,2, Vincent P Lamaro3, Sarah Livingstone3
1Department of Gynaecology, St Vincent's Hospital Sydney, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia. weihowlim@gmail.com.
Surgical Endoscopy
|September 11, 2023
Summary
Pre-operative ureteric catheterization in women undergoing major endoscopic gynecological surgery prevented intra-operative ureteric injuries. This approach also reduced hospital stay and cystoscopy time, demonstrating favorable outcomes and low complication rates.
Area of Science:
- Urology
- Gynecological Surgery
- Surgical Safety
Background:
- Ureteric injuries are a significant concern during gynecological surgery.
- Identifying ureteric course intra-operatively is crucial to prevent morbidity.
- Pre-operative ureteric catheterization is explored as a preventative strategy.
Purpose of the Study:
- To evaluate the effectiveness of pre-operative ureteric catheterization in preventing ureteric injuries during major endoscopic gynecological surgery.
- To compare outcomes between patients who received pre-operative ureteric catheterization and those who did not.
Main Methods:
- A case-controlled study involving 862 women undergoing major endoscopic gynecological surgery.
- Comparison of a study group (pre-operative ureteric catheterization) with a control group (routine post-operative cystoscopy).
Main Results:
- No intra-operative ureteric injuries or complications were observed in the study group.
- The study group had a significantly shorter hospital stay (2 days vs. 5 days) and cystoscopy time (11 min vs. 35 min).
- No long-term morbidity was recorded in the study group.
Conclusions:
- Pre-operative bilateral ureteric catheterization is a favorable strategy for major endoscopic gynecological surgeries, associated with low complication rates.
- Routine or adjunct use of pre-operative ureteric catheterization can help minimize iatrogenic ureteric injuries.
- Combining this technique with meticulous surgical practice enhances patient safety.
Related Concept Videos
01:28Urologic Endoscopic Procedure: Cystoscopic Examination
46
Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
46
01:22Imaging Studies V: Intravenous Urography and Retrograde Pyelography
53
IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
53
01:25Urinary Tract Calculi VI: Surgical Management
10
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
10
01:26Kidney Transplant II: Surgical Procedure
36
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
36
01:22Imaging Studies VI: Voiding Cystourethrography and Cystography
30
Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
30
01:28Imaging Studies I: Kidney, Ureter, and Bladder Studies
25
Kidney, Ureter, and Bladder (KUB) StudiesKidney, Ureter, and Bladder (KUB) studies are standard diagnostic imaging procedures used to assess the anatomy of the urinary system. They are commonly utilized for patients experiencing abdominal pain or urinary symptoms. By using a simple X-ray of the abdomen, KUB studies can reveal structural and pathological abnormalities within the kidneys, ureters, and bladder. These studies are particularly valuable in diagnosing kidney stones, urinary...
25