Perioperative changes in serum creatinine after gynecologic surgery

• Published in: American journal of obstetrics and gynecology Vol. 186; no. 6; pp. 1315 - 1319
• Main Authors: Walter, Andrew J., Magtibay, Paul M., Morse, Abraham N., Hammer, Robert A., Hentz, Joseph G., Magrina, Javier F.
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Mosby, Inc 01.06.2002; Elsevier
• Subjects: Biological and medical sciences; Creatinine; Creatinine - blood; Cystoscopy; Female; gynecologic surgery; Gynecologic Surgical Procedures; Humans; Medical sciences; Postoperative Period; Predictive Value of Tests; Prospective Studies; Sensitivity and Specificity; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the genital tract and mammary gland; Ureter - pathology; Ureter - physiopathology; Ureteral Obstruction - blood; ureteral patency; Creatinine; ureteral patency; gynecologic surgery; cystoscopy; Human; Postoperative; Injury; Gynecology; Urinary bladder; Surgery; Female; Serum; Diagnosis; Endoscopy; Ureter; Quantitative analysis
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1067/mob.2002.122440

Objective: The purpose of this study was to prospectively determine the normal range of postoperative changes in serum creatinine levels when bilateral ureteral patency was confirmed by cystoscopy. Study Design: A total of 187 consecutive patients who had undergone major gynecologic surgery were evaluated prospectively. All patients had undergone perioperative cystoscopy to evaluate for ureteral patency, and creatinine levels had been determined before and 24 hours after surgery. Results: The mean change in serum creatinine level was 0.01 mg/dL, and the changes for the central 95% ranged from −0.2 to 0.3 mg/dL. With a previously defined cutoff value of an increase of >0.2 mg/dL after operation to indicate ureteral obstruction, specificity and negative predictive values (when compared with cystoscopic findings) were 98% and 100%, respectively. Conclusion: Creatinine levels change minimally during the immediate postoperative period in the absence of ureteral compromise. If bilateral ureteral patency was demonstrated after operation in our population, creatinine level elevations were always <0.3 mg/dL. (Am J Obstet Gynecol 2002;186:1315-9.)