Lower urinary tract injury in women in the United States, 1979–2006

• Published in: American journal of obstetrics and gynecology Vol. 202; no. 5; pp. 495.e1 - 495.e5
• Main Authors: Frankman, Elizabeth A., MD, MSc, Wang, Li, MS, Bunker, Clareann H., MPH, PhD, Lowder, Jerry L., MD, MSc
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Mosby, Inc 01.05.2010; Elsevier
• Subjects: Adolescent; Adult; Biological and medical sciences; bladder injury; Cystoscopy; Female; gynecologic surgery; Gynecologic Surgical Procedures - adverse effects; Gynecology. Andrology. Obstetrics; Humans; Hysterectomy - adverse effects; Hysterectomy - statistics & numerical data; Incidence; Injuries of the urinary system. Foreign bodies. Diseases due to physical agents; Leiomyoma - epidemiology; Medical sciences; Nephrology. Urinary tract diseases; Obstetrics and Gynecology; Postoperative Complications - epidemiology; Traumas. Diseases due to physical agents; United States; Ureter - injuries; ureteral injury; Urethra - injuries; Urinary Bladder - injuries; Urinary Incontinence - epidemiology; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland; Uterine Neoplasms - epidemiology; Uterine Prolapse - epidemiology; Young Adult; United States; North America; America; gynecologic surgery; bladder injury; ureteral injury; Human; Lower urinary tract; Urinary system disease; Gynecology; Female; Urinary tract disease; Urinary tract traumatism; Woman; Obstetrics
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2010.01.013

Objective We sought to determine age-adjusted rates (AARs) of lower urinary tract injury and incidence in selected inpatient gynecologic and obstetric procedures. Study Design We utilized the National Hospital Discharge Survey, 1979–2006. AARs of nonobstetric bladder and ureteral injuries and incidence of lower urinary tract injury for various hysterectomy types and deliveries were calculated for women >18 years old. Results Overall AARs of ureteral injury decreased from 0.06–0.03 per 1000 women (1979–2006). AARs of inpatient gynecologic procedures decreased from 24.9–11.8 per 1000 women (1979–2006). By hysterectomy type, bladder injury was highest in laparoscopic-assisted vaginal hysterectomy (VH) (13.8 per 1000) and VH (13.1 per 1000). Ureteral injury recognized during hysterectomy was most common with radical hysterectomy (7.7 per 1000) and least common with laparoscopic-assisted VH (0 per 1000). Conclusion Ureteral injuries at time of inpatient surgical procedures have decreased from 1979–2006. This corresponds with a sharp decrease in inpatient gynecologic procedures.