Management of urinary bladder injuries in laparoscopic assisted vaginal hysterectomy

Chyi Long Lee*, Ying Ming Lai, Yung Kuei Soong

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

19 Scopus citations

Abstract

Background. To illustrate our experience and evolution in management of urinary bladder injury in laparoscopically assisted vaginal hysterectomy. Methods. Four hundred and twenty-two women underwent laparoscopically assisted vaginal hysterectomy with or without adnexectomy during the period March 1991-September 1994. The indicators for hysterectomy included adenomyosis, myoma uteri, intractable menorrhagia, endometriosis and severe pelvic adhesion. There are six cases of urinary bladder injuries resulting from our 422 cases of laparoscopically assisted vaginal hysterectomy. Results. The first two cases of urinary bladder injuries were repaired through exploratory laparotomy. The third case was repaired through laparoscopic intracorporeal suture. The technique of the automatic linear stapler through laparoscopy was used in case 4. The last two cases were repaired vaginally. All these patients recovered well after primary repair with an indwelling catheter for five to seven days regardless of the method of repair. The operation time for repairing the injuries is shortest in vaginal approach. Conclusions. The urinary bladder injury is one of the most common complications associated with laparoscopically assisted vaginal hysterectomy. Early detection and treatment enable complications to be overcome easily. As the laparoscopist acquires further experience in dealing with these complications, the urinary bladder injury may be managed laparoscopically. However, vaginal approach may be an easier way in dealing with this complication. Thus, most laparotomy or high technique laparoscopically repair could be avoided.

Original languageEnglish
Pages (from-to)174-177
Number of pages4
JournalActa Obstetricia et Gynecologica Scandinavica
Volume75
Issue number2
DOIs
StatePublished - 1996
Externally publishedYes

Keywords

  • Laparoscopically assisted vaginal hysterectomy (LAVH)
  • Urinary bladder injury
  • Vaginal approach

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