TY - JOUR
T1 - Risk factors for ureteral occlusion during transvaginal uterosacral ligament suspension
AU - Jackson, Elisha
AU - Bilbao, Jorge A.
AU - Vera, Robert W.
AU - Mulla, Zuber D.
AU - Mallett, Veronica T.
AU - Montoya, T. Ignacio
N1 - Publisher Copyright:
© 2015, The International Urogynecological Association.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Introduction and hypothesis: To determine any risk factors associated with ureteral occlusion during transvaginal uterosacral ligament suspension (USLS). Methods: A retrospective query to identify patients that underwent transvaginal USLS at a teaching hospital from 2008 to 2013 was performed. Patients in which ureteral occlusion was identified by cystoscopy were identified (cases), and compared with those without occlusion (controls). Medical records were reviewed for data abstraction. Variables compared between cases and controls included demographics, medical history/examination, concomitant procedures, number of suspension sutures placed, estimated blood loss and length of hospital stay. Univariate analyses were performed to identify potential risk factors for ureteral occlusion, followed by multivariate regression analysis to estimate odds ratios for identified predictors. Results: A total of 144 USLS procedures were performed. Thirteen cases of ureteral occlusion were identified (9%). Baseline prolapse stage, body mass index, parity, previous hysterectomy or pelvic surgery of the groups were similar (all P > 0.05). Univariate analysis identified age (P = 0.04), concomitant anterior colporrhaphy (P = 0.01), and use of a suture-capturing device for suture placement (P = 0.04) as significant factors. On multivariate logistic regression analysis, concomitant anterior colporrhaphy increased ureteral occlusion risk (OR 10.5, 95%CI 2.37–74.99, P = 0.001), while use of a suture-capturing device decreased it (OR 0.1, 95%CI 0–0.41, P = 0.01). The mean number of suspension sutures placed per side was similar in the two groups (2.6 [range 2–4] for cases and 2.4 [range 1–4] for controls, P = 0.15). Conclusions: During transvaginal USLS, performance of a concomitant anterior colporrhaphy increased the risk of ureteral occlusion, while the use of a suture-capturing device for suspension suture placement was associated with decreased risk.
AB - Introduction and hypothesis: To determine any risk factors associated with ureteral occlusion during transvaginal uterosacral ligament suspension (USLS). Methods: A retrospective query to identify patients that underwent transvaginal USLS at a teaching hospital from 2008 to 2013 was performed. Patients in which ureteral occlusion was identified by cystoscopy were identified (cases), and compared with those without occlusion (controls). Medical records were reviewed for data abstraction. Variables compared between cases and controls included demographics, medical history/examination, concomitant procedures, number of suspension sutures placed, estimated blood loss and length of hospital stay. Univariate analyses were performed to identify potential risk factors for ureteral occlusion, followed by multivariate regression analysis to estimate odds ratios for identified predictors. Results: A total of 144 USLS procedures were performed. Thirteen cases of ureteral occlusion were identified (9%). Baseline prolapse stage, body mass index, parity, previous hysterectomy or pelvic surgery of the groups were similar (all P > 0.05). Univariate analysis identified age (P = 0.04), concomitant anterior colporrhaphy (P = 0.01), and use of a suture-capturing device for suture placement (P = 0.04) as significant factors. On multivariate logistic regression analysis, concomitant anterior colporrhaphy increased ureteral occlusion risk (OR 10.5, 95%CI 2.37–74.99, P = 0.001), while use of a suture-capturing device decreased it (OR 0.1, 95%CI 0–0.41, P = 0.01). The mean number of suspension sutures placed per side was similar in the two groups (2.6 [range 2–4] for cases and 2.4 [range 1–4] for controls, P = 0.15). Conclusions: During transvaginal USLS, performance of a concomitant anterior colporrhaphy increased the risk of ureteral occlusion, while the use of a suture-capturing device for suspension suture placement was associated with decreased risk.
KW - Ureteral injury
KW - Uterosacral ligament suspension
KW - Vaginal prolapse surgery
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U2 - 10.1007/s00192-015-2770-1
DO - 10.1007/s00192-015-2770-1
M3 - Article
C2 - 26174656
AN - SCOPUS:84948752184
SN - 0937-3462
VL - 26
SP - 1809
EP - 1814
JO - International Urogynecology Journal
JF - International Urogynecology Journal
IS - 12
ER -