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Human Reproduction, Vol. 14, No. 7, 1727-1729, July 1999
© 1999 European Society of Human Reproduction and Embryology

The value of intra-operative cystoscopy at the time of laparoscopic hysterectomy

Sergio Ribeiro1,3,4, Harry Reich1,3, Jay Rosenberg1,3, Enrica Guglielminetti2,3 and Andrea Vidali1,2,3,5

1 Division of Advanced Laparoscopic Surgery 2 Division of Reproductive Endocrinology, Columbia Presbyterian Medical Center 3 Columbia University College of Physicians and Surgeons, New York, New York, USA 4 Hospital das Clinicas da FMUSP, Rua Eneas de Carvalho Aguiar, 255, 10° andar, sala 10167São Paulo, Brasil CEP 05403–000

The aim of this study was to determine the usefulness of routine intra-operative cystoscopy in documenting ureteral injury during total laparoscopic hysterectomy with vault suspension and to document the incidence of this complication in a large series. The charts of 118 patients who underwent laparoscopic hysterectomy with vault suspension from January 1992 to January 1998 were retrospectively reviewed. The patients underwent intra-operative cystoscopic evaluation to verify ureteral permeability and bladder integrity. Intra-operative ureteral obstruction occurred in four patients (3.4%). All complications were immediately fixed and there were no postoperative ureteral problems. No late ureteral complications were observed. Intra-operative cystoscopy allows for early recognition and treatment of obstructive ureteral injuries and may reduce the rate of late postoperative complications during advanced laparoscopic procedures.

Key words: complications/cystoscopy/hysterectomy/laparoscopy/ureter

5 To whom correspondence should be addressed at: Department of Obstetrics and Gynecology, 622 W 168th Street PH-16, New York, NY 10032, USA


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