Are ureteral catheters in gynecologic surgery beneficial or hazardous?

STUDY

OBJECTIVE

To evaluate the use of ureteral catheters in gynecologic surgery.

DESIGN

A prospective study.

SETTING

A university-affiliated private hospital.

PATIENTS: A series of 317 women undergoing a variety of gynecologic surgeries who were at high risk for ureteral injury.

INTERVENTIONS: The procedures ranged from radical oncologic surgery to difficult operations for benign disease. In 273 patients the ureteral catheters were inserted prophylactically, and in 44 they were inserted postoperatively to confirm ureteral patency. Nineteen were lighted catheters used during laparoscopic surgery.

MEASUREMENTS AND MAIN

RESULTS

Only 3 of 546 ureters could not be catheterized preoperatively. The average time to insert the catheters was 6 minutes (range 2-21 min). All ureters were easily identified, and their dissection was facilitated by the catheters. Two asymptomatic cases of transitional cell cancer of the bladder were diagnosed. One case of ureteral obstruction was identified at postoperative ureteral catheter insertion. No immediate or delayed problems were identified. The frequency of urinary tract infection was 3.2%.

CONCLUSION

Ureteral catheters are safe and are simple to insert. They enhance identification of ureters and facilitate ureteral dissection.