The risk of ureteric injury associated with hysterectomy: a 10-year retrospective cohort study.

Abstract

To evaluate the rates of ureteric injury among women undergoing hysterectomy. Retrospective cohort. English National Health Service hospitals. Women undergoing hysterectomy in 2001-2010. Unadjusted rates of ureteric injury, within 1year of hysterectomy, calculated by indication and type of procedure. Multivariable logistic regression used to assess the risk of ureteric injury with year of surgery. Ureteric injury within a year of the hysterectomy. In 2001-2010, 377073 women underwent hysterectomy, of whom 1792 (0.5%) experienced a ureteric injury. In both benign and malignant groups the rate of injury was higher in 2006-2010 than 2001-2005. After 2006, ureteric injuries were most common for abdominal radical hysterectomy for uterine cancer (10.7%; 95% CI 7.3-15.1%). The proportion of women having a ureteric injury was similar for ovarian and cervical cancer (1.9-4.0% depending on type of procedure). For benign conditions, the rate of injury tended to be lower, typically <1%. Women with endometriosis had the highest risk among this group (1.7% following total abdominal hysterectomy; 95% CI 1.4-2.0%). The risk of ureteric injury within 1year of hysterectomy varied by type of hysterectomy for benign and malignant conditions. The rates of injury have increased between 2001 and 2010. Ten-year study shows ureteric injury rates have increased.