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Eom, Lee, Kim, Hong, Lee, Choi, and Joo: Clinical efficacy on laparoscopic management of genitourinary tract injuries in gynecological surgery
Original Article
Korean Journal of Obstetrics & Gynecology

Korean Journal of Obstetrics & Gynecology 2011; 54(4): 199-204.

Published online: 30 April 2011

DOI: https://doi.org/10.5468/KJOG.2011.54.4.199

Clinical efficacy on laparoscopic management of genitourinary tract injuries in gynecological surgery

Jeong Min Eom, MD, Jung Hun Lee, MD, Jee Yeon Kim, MD, Jin Hwa Hong, MD, Kyo Won Lee, MD, Joong Sub Choi, MD, Kwan Joong Joo, MD

Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Corresponding author: Joong Sub Choi MD, PhD. Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyeong-dong, Jongno-gu, Seoul 110-746, Korea. Tel: +82-2-2001-2499, Fax: +82-2-2001-2187, yjjy.choi@samsung.com, choiyjjy@skku.edu

Received 22 May 2010       Revised 28 March 2011       Accepted 4 April 2011

Copyright © 2011. Korean Society of Obstetrics and Gynecology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

To assess efficacy and feasibility of laparoscopic surgery for genitourinary tract injuries related with gynecological surgery.

Methods

We conducted a retrospective study of 38 patients undergoing laparoscopic surgery to treat genitourinary tract injury which occurred during gynecologic surgery in Kangbuk Samsung Hospital from March 2003 to February 2010. We analyzed the demographic and clinical characteristics including history of previous abdominal surgery, the type of injury, type of repair procedure, and any complications.

Results

Of the 38 patients, 27 had urinary bladder injury, six had ureter injury including ureterovaginal fistula in one, and five had vesicovaginal fistula. The median age of patients, the median body mass index, and the median follow-up period were 45 years (31 to 71 years), 21.4 kg/m2 (18.8 to 31.4 kg/m2), and 39 months (16 to 78 months), respectively. There were no laparoconversions. No intraoperative or postoperative complications occurred. All patients have been asymptomatic, and their follow-up intravenous pyelograms and ultrasound examinations have been normal.

Conclusion

Laparoscopic repair of genitourinary tract injuries occurred during gynecologic surgery is feasible for experienced laparoscopic surgical team in gynecology.

Keywords: Laparoscopy, Genitourinary tract injury, Ureter injury, Bladder injury, Vesicovaginal fistula

Figures and Tables

Table 1
Incidence of urinary tract injury
kjog-54-199-i001

Values are presented as number (%).

aBy the Fisher's exact test.

Table 2
Characteristics of patients with urinary tract injury
kjog-54-199-i002
Table 3
Urinary tract injuries and urological procedures
kjog-54-199-i003

LRVH, laparoscopic radical vaginal hysterectomy; LSO, left salpingo-oophorectomy; LPL, laparoscopic pelvic lymphadenectomy; LPAL, laparoscopic paraaortic lymphadenectomy; LA, laparoscopic appendectomy; BSO, bilateral salpingooophorectomy.

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