Our Summary

This study looked at whether a certain type of surgery (minimally invasive laparoscopic surgery) used for benign hysterectomies could increase the risk of injury to the vesicoureteral area (the system that carries urine from the kidneys to the bladder) compared to a different kind of surgery (laparotomy).

The researchers analyzed data from over 500,000 women who underwent different types of hysterectomy surgeries. They found that the overall risk of vesicoureteral injury is low, regardless of the type of surgery. However, they did find that one specific type of minimally invasive surgery (total laparoscopic hysterectomy) had a higher risk of causing injury to the ureter (the tube that carries urine from the kidneys to the bladder) compared to a total abdominal hysterectomy.

This risk was particularly high when the surgery was performed for certain conditions like endometriosis or uterine myoma. However, other types of minimally invasive surgeries did not show an increased risk of vesicoureteral injury.

In other words, the type of surgery used for a hysterectomy can impact the risk of injury to the urinary system, but the overall risk is still quite low.

FAQs

  1. Does minimally invasive laparoscopic surgery for benign hysterectomies increase the risk of injury to the vesicoureteral area?
  2. Is there a difference in vesicoureteral injury risk between total laparoscopic hysterectomy and total abdominal hysterectomy?
  3. Does the condition for which the hysterectomy is performed, such as endometriosis or uterine myoma, affect the risk of vesicoureteral injury during surgery?

Doctor’s Tip

Therefore, it is important to discuss with your doctor the best surgical approach for your specific condition and to ensure they have experience with the type of surgery being recommended. Additionally, following post-operative care instructions, such as avoiding heavy lifting and taking prescribed medications, can help reduce the risk of complications. If you experience any unusual symptoms such as persistent pain, fever, or difficulty urinating after surgery, it is important to contact your doctor immediately.

Suitable For

Patients who are typically recommended for laparoscopic hysterectomy are those with benign conditions such as fibroids, endometriosis, or abnormal uterine bleeding. Laparoscopic hysterectomy is often preferred for these patients because it is minimally invasive, resulting in shorter hospital stays, faster recovery times, and less post-operative pain compared to traditional open surgery (laparotomy).

However, it is important for patients to discuss their individual risk factors and medical history with their healthcare provider to determine the best surgical approach for their specific situation.

Timeline

Before a laparoscopic hysterectomy, a patient may undergo diagnostic tests, consultation with their healthcare provider, and pre-operative preparations such as fasting and medication adjustments. The patient will also receive information about the procedure, potential risks, and post-operative care.

During the laparoscopic hysterectomy procedure, small incisions are made in the abdomen to insert a camera and surgical instruments. The uterus is then removed through these small incisions, resulting in less scarring and a shorter recovery time compared to traditional open surgery.

After the laparoscopic hysterectomy, the patient will be monitored for any complications and may experience some pain, discomfort, and bloating. Recovery time is typically shorter compared to open surgery, with most patients able to return to normal activities within a few weeks. Follow-up appointments will be scheduled to monitor healing and address any concerns.

What to Ask Your Doctor

Some questions a patient should ask their doctor about laparoscopic hysterectomy include:

  1. What are the benefits of laparoscopic hysterectomy compared to other types of hysterectomy?

  2. What are the potential risks and complications associated with laparoscopic hysterectomy, including the risk of injury to the urinary system?

  3. How many laparoscopic hysterectomies have you performed, and what is your experience with this procedure?

  4. Are there any specific factors that could increase my risk of vesicoureteral injury during a laparoscopic hysterectomy?

  5. How will you monitor for and prevent injury to the urinary system during the surgery?

  6. What is the recovery process like after a laparoscopic hysterectomy, and how long will it take to return to normal activities?

  7. Are there any alternative treatment options to consider for my condition, and how do they compare to laparoscopic hysterectomy in terms of risk and benefits?

  8. What should I expect in terms of follow-up care and monitoring after the surgery?

  9. Can you provide me with more information or resources to help me make an informed decision about undergoing a laparoscopic hysterectomy?

Reference

Authors: Chang EJ, Mandelbaum RS, Nusbaum DJ, Violette CJ, Matsushima K, Klar M, Matsuzaki S, Machida H, Kanao H, Roman LD, Matsuo K. Journal: J Minim Invasive Gynecol. 2020 Sep-Oct;27(6):1354-1362. doi: 10.1016/j.jmig.2019.11.004. Epub 2019 Nov 16. PMID: 31743796