Aim: The purpose of this study is to determine the (1) importance of liberal use of intraoperative cystoscopy in routine gynecological surgeries for detection of urinary tract injuries, (2) time taken for intraoperative cystoscopy, and (3) complications associated with cystoscopy.
Materials and methods: The study was started in March 2015 that enrolled 170 patients up to June 2016 with a follow-up period of 12 months.
Settings and design: Prospective study in a tertiary care center. Patients undergoing all gynecological and urogynecological surgeries were included in the study. Malignancy was excluded. Cystourethroscopy was performed following gynecological surgery using a 20 F 30° telescope. A study pro forma was prepared to record case information.
Results: Three bladder injuries were diagnosed by intraoperative cystoscopy during antiincontinence surgery [tension-free vaginal tape (TVT)] and hysterectomy. Following total laparoscopic hysterectomy (TLH) with normal cystoscopy, one patient returned 1 month postoperatively with right ureteric injury. Three patients had immediate postoperative urinary tract infection. One patient complained of flank pain with fever 48 hours following surgery. Further investigation with computed tomography intravenous pyelogram (CT IVP) was negative for urinary tract injury. She was treated conservatively.
Conclusion: Obstetricians/gynecologists (OB-GYNs) should have a low threshold to perform intraoperative cystoscopy during gynecological surgeries for early detection of urinary tract injuries.
Clinical significance: Early recognition and repair of urinary tract injuries lead to decreased morbidity for the patient, with successful outcome of repair at the time of detection. This is possible by performing an intraoperative cystoscopy during gynecological surgeries.
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