Prophylactic ureteric catheterization before pelvic surgery in Rajavithi Hospital

Abstract

Objective: To evaluate the incidence and the correlation between the risk factors of ureteric injury and complications in patients who underwent prophylactic ureteric catheterization before pelvic surgeries. Material and Method: From October 2015 to December 2018, the medical records of 130 patients in Rajavithi Hospital who underwent pelvic surgeries and prophylactic ureteric catheterization were retrospectively reviewed. Information included age, history of previous pelvic surgeries, pelvic radiation, presence of hydronephrosis, pathology, stage of cancer, injury of ureters, and complications. Results: Incidence of ureteric injury was 4.6% (n=6). The significant risk of injury was location of the tumor at the ovary (p=0.034); borderline significant risk was malignant pathology (p=0.057). After the procedure, 16.2% (n=21) of the patients had gross hematuria and 14.6% (n=19) of the patients had a urinary tract infection. Average time of catheterization was 20.95 minutes. Significant risk of gross hematuria was older age (p<0.001) and malignant pathology (p=0.006). Conclusion: From this study, ureteric injury may be significantly higher in cases of malignancy at the ovary and may not prevent injury in high-risk patients. Ureteric catheterization should be carefully considered in elderly patients because of the higher rate of complications.