Analysis of the use of prophylactic ureteral stents in preventing iatrogenic ureteral injury during radical hysterectomy for cervical Cancer.

OBJECTIVE

To assess the use of prophylactic ureteral stent for preventing ureteral injury in patients with cervical cancer undergoing radical hysterectomy.

METHODS

This retrospective study included 304 patients with cervical cancer who underwent abdominal radical hysterectomy at Qilu Hospital of Shandong University (Qingdao) from June 2018 to June 2023. Patients were divided into the ureteral stent group (129 cases) and the control group (175 cases). The value of the use of prophylactic ureteral stents was compared between two groups in terms of ureteral and bladder injury rates, ureteral strictures, urinary system complications and cost-effectiveness.

RESULTS

There was no statistically significant difference in the incidence of ureteral and bladder injury between the two groups (P > 0.05). Postoperative radiotherapy was given to 59 patients in the stent group and 89 patients in the control group. There were 16 (27.1 %) and 5 (5.6 %) cases of ureteral stricture in the stent and control groups after the end of radiotherapy. The prevalence of ureter stricture in the two groups were significantly different (P < 0.05). There was no statistically significant difference in the incidence of newly emerged ureteral strictures caused by radiotherapy between the two groups (6.5 % vs. 2.3 %, P > 0.05). The incidences of urinary complications were statistically significant between the two groups (P < 0.05). Operation time, surgery cost and hospitalization expenses were higher in the stent group, which increased the total medical cost.

CONCLUSION

The use of prophylactic ureteral stent did not reduce the occurrence of ureteral injuries in patients undergoing abdominal radical hysterectomy, nor prevent the incidence of ureteral stricture after radiotherapy. On the contrary, the use of ureteral stent increased the incidence of urinary complications and medical cost.