Prophylactic ureteral catheterization for prevention of ureteral injury during radical hysterectomy

Objective To study the significance of prophylactic ureteral catheterization for prevention of ureteral injury during radical hysterectomy. Methods Four hundred and thirty-eight patients with cervical cancer who underwent radical hysterectomy from January 2006 to January 2011 in our hospital were retrospectively analyzed.Of these patients,40 underwent ureteral catheterization including double-J stent implantation under cystoscope before operation.The stent was removed immediately or 3 months after operation. Results Ureteral injury was found in 1 of the 40 patients who underwent ureteral catheterization before operation and naturally healed without specific repair 3 months after the catheter was removed.Ureteral injury was found in 6 of the 230 patients who underwent abdominal surgery.Among these 6 patients,ureteral fistula was found in 1 and repaired with a dwelling ureteral catheter,tumor invasion or dense adhesion was observed in the other 5 and removed followed by implantation of a vesicoureteral catheter.Ureteral injury was found in 7 of the 208 patients who underwent laparoscopic surgery.Among these 7 patients,ureteral injury was observed in 3 during operation,which was naturally healed in 1 patient without specific repair due to the inserted D-J stent before operation,repaired in 1 patient though laparoscopy followed by implantation of a D-J stent,repaired in 1 patient after trans-abdominal implantation of a D-J stent.Thermal injury was found in 4 patients 14 days after operation,which was simply treated in 1 patient by implanting a double-J stent under cystoscope,repaired by laparoscopy in 2 patients with a dwelling double-J stent,and repaired in 1 patient with pelvic fistulization. Conclusion Prophylactic ureteral catheterization for cervical cancer helps to identify ureter,prevent and treat ureteral injury during radical hysterectomy.