Laparoscopic Hysterectomy and Urinary Tract Injury: Experience in a Health Maintenance Organization

Jasmine Tan-Kim, Tan-Kim J, Shawn A. Menefee, Menefee SA, Caryl S. Reinsch, Reinsch CS, Cristina H. O'Day, O'Day CH, Bebchuk J, Judith Bebchuk, Judith D. Bebchuk, Kennedy JS, John S Kennedy, John Kennedy, Emily L. Whitcomb, Whitcomb EL
Journal of Minimally Invasive Gynecology · 2015 · vol. 22(7) , pp. 1278–1286 · doi:10.1016/j.jmig.2015.07.016 · PMID:26241687 · W2138410195
Observational OA: closed CC0 ⤵ 6 in-corpus citations
View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-08 ⓘ

This study investigated the incidence and management of urinary tract injuries during laparoscopic hysterectomies within a health maintenance organization.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

STUDY OBJECTIVES: To evaluate the incidence, detection, characteristics, and management of urinary tract injury in a cohort undergoing laparoscopic hysterectomy, and to identify potential risk factors for urinary tract injury with laparoscopic hysterectomy. DESIGN: Retrospective analysis (Canadian Task Force classification II-2). SETTING: Kaiser Permanente San Diego Medical Center, 2001 to 2012. PATIENTS: Women who underwent attempted laparoscopic hysterectomy for benign indications. INTERVENTIONS: Total laparoscopic hysterectomy, laparoscopic-assisted vaginal hysterectomy, and laparoscopic supracervical hysterectomy. MEASUREMENTS AND MAIN RESULTS: Demographic and clinical characteristics, surgical techniques, and perioperative complications were abstracted from the medical record. Multivariable logistic regression analysis assessed independent risk factors for ureteral or bladder injury. RESULTS: A total of 3523 patients (mean age, 45.9 ± 8.0 years; median parity, 2; range, 0-10), with a median body mass index (BMI) of 29 kg/m(2) (range, 16-72 kg/m(2)), underwent laparoscopic hysterectomy; 20% had intraoperative cystoscopy. The incidence of urinary tract injury was 1.3% (46 of 3523); of the 46 patients with injuries, 19 (0.54%) had ureteral injuries, 25 (0.71%) had bladder injuries, and 2 (0.06%) had both types. Of the 21 ureteral injuries, 6 (29%) were diagnosed intraoperatively and 15 (71%) were diagnosed postoperatively, including 4 with normal intraoperative cystoscopy. Of the 27 bladder injuries, 23 (85%) were identified intraoperatively. In multivariable logistic analysis, a BMI of 26 to 30 kg/m(2) (compared with >30 kg/m(2)) was associated with an increased risk of ureteral injury, and a BMI ≤25 kg/m(2) (compared with >30 kg/m(2)) and the presence of endometriosis were associated with an increased risk of bladder injury. CONCLUSION: Urinary tract injury occurred in 1.3% of laparoscopic hysterectomies, with ureteral injuries almost as common as bladder injuries. Normal intraoperative cystoscopy findings did not exclude the presence of ureteral injury.

My notes (saved in your browser only)

MeSH descriptors

Cystoscopy Hysterectomy, Vaginal Laparoscopy Ureter Urinary Bladder Cystoscopy Cystoscopy Female Female Health Maintenance Organizations Health Maintenance Organizations Humans Humans Hysterectomy, Vaginal Hysterectomy, Vaginal Incidence Incidence Laparoscopy Laparoscopy Middle Aged

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (15)

Cited by (7)

Source provenance

europepmc
last seen: 2026-10-10T06:11:15.153948+00:00
openalex
last seen: 2026-06-04T00:00:01.174412+00:00
pubmed
last seen: 2026-10-08T21:16:08.491429+00:00
License: CC0 · commercial use OK