Needlestick Injury During Urological Surgery: A 15-Year Review From a Multi-Institutional Study in the...

Needlestick injuries (NSIs) are a major occupational hazard for healthcare workers and remain a concern during surgery. However, data specific to urologic surgery are limited. This multicenter retrospective study analyzed NSIs across seven Japanese institutions to clarify their characteristics and propose preventive strategies.

We reviewed 63 590 urologic surgeries performed between April 2009 and March 2024 at seven university hospitals. Forty-six NSI cases were identified, of which 44 with complete data were analyzed. Collected variables included procedure type, surgeon experience, injury details, and infection status. Bleeding severity was classified as superficial (controlled by spontaneous hemostasis or light compression only) or moderate (requiring strong compression or additional hemostatic procedures such as sealing or suturing).

The overall incidence of NSIs was 0.06% (range, 0.01%-0.24%). Suture needles were responsible for 75.0% of cases, and 61.4% occurred during wound closure, of which 92.6% involved suture needles. NSIs during wound closure were significantly more common in robot-assisted/laparoscopic procedures than in open/other procedures (88.9% vs. 42.3%, p = 0.005). Injuries predominantly affected the first to third digits (77.3%). Moderate bleeding was observed more often in dominant-hand injuries, although the difference did not reach statistical significance (31.3% vs. 10.7%, p = 0.102).

NSIs in urologic surgery most often occur during wound closure and involve suture needles, particularly in robot-assisted and laparoscopic procedures. The first to third digits are most frequently affected, and dominant-hand injuries tend to cause more bleeding. Preventive measures-including safer suturing techniques, double gloving, and finger protection-are warranted to reduce the risk.