MP25-10 PREVENTION AND DETECTION OF IATROGENIC URETERAL INJURY DURING ABDOMINAL OR PELVIC SURGERY: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

You have accessJournal of UrologyCME1 May 2022MP25-10 PREVENTION AND DETECTION OF IATROGENIC URETERAL INJURY DURING ABDOMINAL OR PELVIC SURGERY: A SYSTEMATIC REVIEW AND META-ANALYSIS Takafumi Yanagisawa, Keiichiro Mori, Reza Sari Motlagh, Tatsushi Kawada, Hadi Mostafaei, Fahad Quhal, Ekaterina Laukhtina, Pawel Rajwa, Frederik König, Maximilian Pallauf, Benjamin Pradere, Jun Miki, Takahiro Kimura, Shin Egawa, and Shahrokh F. Shariat Takafumi YanagisawaTakafumi Yanagisawa More articles by this author , Keiichiro MoriKeiichiro Mori More articles by this author , Reza Sari MotlaghReza Sari Motlagh More articles by this author , Tatsushi KawadaTatsushi Kawada More articles by this author , Hadi MostafaeiHadi Mostafaei More articles by this author , Fahad QuhalFahad Quhal More articles by this author , Ekaterina LaukhtinaEkaterina Laukhtina More articles by this author , Pawel RajwaPawel Rajwa More articles by this author , Frederik KönigFrederik König More articles by this author , Maximilian PallaufMaximilian Pallauf More articles by this author , Benjamin PradereBenjamin Pradere More articles by this author , Jun MikiJun Miki More articles by this author , Takahiro KimuraTakahiro Kimura More articles by this author , Shin EgawaShin Egawa More articles by this author , and Shahrokh F. ShariatShahrokh F. Shariat More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002568.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Iatrogenic ureteral injury is rare but severe complication that can occur during abdominal or pelvic surgery, however robust data regarding optimal method for its prevention and management is still missing. METHODS: Multiple databases were searched for articles published before August 2021. Studies were deemed eligible if they evaluated the differences in the rate of ureteral injury between laparoscopic and open surgery, prophylactic ureteral stent indwelling or not and the differences in the rate of final treatment success between intraoperative and postoperative detection, in patients who underwent gynecological or colorectal surgery. RESULTS: Overall, 46 studies were eligible for this meta-analysis, comprising 491,519 patients for incidence analysis and 3,186 ureteral injuries for treatment outcome analysis. Pooled ureteral injury rate was 0.356% in colectomy and 0.334% in hysterectomy. Compared to open surgery, laparoscopic surgery was associated with a higher incidence of ureteral injury in hysterectomy (pooled risk ratio [RR]; 2.37, 95% Confidence Intervals [CI]; 1.84-3.06), but not in colectomy (pooled RR; 1.26, 95% CI; 0.77-2.06). Prophylactic ureteral stent indwelling was associated with a lower incidence of ureteral injury in gynecological surgery (pooled RR; 0.62, 95%CI; 0.39-0.96), but not in colorectal surgery (pooled RR; 3.29, 95%CI; 0.80-13.44). Intraoperative detection of ureteral injury was associated with higher rate of treatment success compared to postoperative detection (pooled RR; 0.24, 95%CI; 0.14-0.40). CONCLUSIONS: Prophylactic ureteral stent indwelling can help not only detect the ureter intraoperatively, but also lessen the rate of ureteral injury in gynecological surgery. Furthermore, our analyses suggest that intraoperative detection of ureteral injury during abdominal/pelvic surgery led to higher success rate after repair surgery. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e431 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Takafumi Yanagisawa More articles by this author Keiichiro Mori More articles by this author Reza Sari Motlagh More articles by this author Tatsushi Kawada More articles by this author Hadi Mostafaei More articles by this author Fahad Quhal More articles by this author Ekaterina Laukhtina More articles by this author Pawel Rajwa More articles by this author Frederik König More articles by this author Maximilian Pallauf More articles by this author Benjamin Pradere More articles by this author Jun Miki More articles by this author Takahiro Kimura More articles by this author Shin Egawa More articles by this author Shahrokh F. Shariat More articles by this author Expand All Advertisement PDF DownloadLoading ...