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urinary tract injury during hysterectomy:Does surgeon specialty and surgical volume matter?

World Journal of Methodology 2023年第2期13卷 18-25页

作者： Emilee Khair Fareeza Afzal Sanjana Kulkarni Beaux Duhe' Karen Hagglund Muhammad Faisal Aslam Department of Obstetrics and Gynecology Ascension St JohnDetroitMI 48236United States Department of Obstetrics and Gynecology St.George's University School of MedicineGreat RiverNY 11739United States Department of Medical Research Ascension St JohnDetroitMI 48236United States

BACKGROUND Ureteral injury is a known complication of *** studies have attempted to correlate surgeon volume and experience with incidence of urinary tract injuries during *** studies have reported that as surgeon volume increases,urinary tract injury rates *** our knowledge,no studies have assessed the relationship between surgeon subspecialty and the rate of urinary tract injury rates during minimally invasive *** To determine the incidence of urinary tract injury between urogynecologists,gynecologic oncologists,and general *** The study took place from January 1,2016 to December 1,2021 at a large comm-unity hospital in Detroit,*** conducted a retrospective chart review of adult patients who underwent minimally invasive *** we identified eligible patients,the surgeon subspecialty was identified and the surgeon’s volume per year was *** demographics,medical history,physician-dictated operative reports,and all hospital visits postoperatively were *** Urologic injury occurred in four patients(2%)in the general gynecologist group,in one patient(1%)in the gynecologic oncologist group,and in one patient(1%)in the urogynecologist *** comparing high and low-volume surgeons,there was no statistically significant difference in urinary tract injury(1%vs 2%)or bowel injury(1%vs 0%).There were more complications in the low-volume group vs the high-volume group excluding urinary tract,bowel,or major vessel ***-volume surgeons had four(1%)patients with a complication and low-volume surgeons had 12(4%)patients with a complication(P=0.04).CONCLUSION Our study demonstrated that there was no difference in the urinary tract injury rate in general gynecologists vs subspecialists,however our study was underpowered.

关键词： Minimally invasive hysterectomy urinary tract injury Surgeon volume High volume gynecologist Low volume gynecologist

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Perinephric urinoma,an unusual upper tract presentation of a lower tract injury following retroperitoneoscopy:A case report

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World Journal of Clinical Urology 2021年第1期10卷 1-6页

作者： Arjunan Kumaran Po Man Yeung Raj Tiwari Department of Urology Sengkang General HospitalSingapore 544886Singapore Department of Surgery Sengkang General HospitalSingapore 544886Singapore

BACKGROUND A 66-year-old lady was referred to urology for a suspected urinoma after retroperioneoscopy done for debridement of a retroperitoneal abscess that developed following a duodenal *** SUMMARY Serous contents of the drain sent for fluid creatinine were elevated confirming this and computed tomography urography findings suggested an upper tract injury with urinoma around the ***,the antegrade nephrostogram suggested otherwise and on flexible cystoscopy and cystogram,an extraperitoneal bladder perforation was instead identified,with tip of retroperitoneal drain sitting inside the *** This case identifies a limitation in the usual diagnostic approach for such injuries and emphasizes the need to exercise caution when managing them especially when they occur after several surgical procedures and in the presence of multiple surgical drains.

关键词： Urinoma urinary tract injury Retroperitoneoscopy Complication Diagnosis Radiology Case report

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