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Aust NZ J Obst Gynaeco - 2022 - Foo - Implementation of a policy of universal cystoscopy at the time of hysterectomy for154.39 kB
Published VersionCC BY V4.0, Open Access
Journal article
Implementation of a policy of universal cystoscopy at the time of hysterectomy for benign indications: A retrospective comparative study
Australian and New Zealand Journal of Obstetrics and Gynaecology, Vol.63(1), pp.99-104
2023
Appears in UniSC Supported Open Access Outputs
Abstract
Background:
Lower urinary tract injury (LUTI) is a serious complication of major gynaecologic surgery. Although intra-operative cystoscopy can facilitate timely diagnosis and treatment of LUTI, the optimal approach to cystoscopy at the time of benign hysterectomy remains debatable.
Aims:
To assess whether implementation of a policy of universal cystoscopy at the time of benign hysterectomy was associated with a difference in intra-operative detection and rates of LUTI.
Materials and Methods:
Retrospective cohort study at a large regional teaching hospital where a policy of universal cystoscopy at the time of benign hysterectomy was implemented on 30 September 2019. Hysterectomies performed from 1 November 2016 to 31 March 2021 were included and categorised into the ‘pre-policy’ and ‘post-policy’ groups. Primary outcomes included the intra-operative detection and overall rates of LUTI. Secondary outcome was the policy adherence rate. Multivariate analysis was used to examine the effect of this policy on the outcomes.
Results:
There were 584 hysterectomies identified, including 325 in the pre-policy group and 259 in the post-policy group. Cystoscopy was performed in 55.1% in the pre-policy group and 97.7% in the post-policy group (P < 0.01). Adjusted for age, indication and route of hysterectomy, there were no significant differences in the intra-operative cystoscopic detection of LUTI (42.9% vs 25.0%, P = 0.55) or the rate of LUTI (2.2% vs 1.5%, P = 0.25) after implementation of the policy.
Conclusions:
The practice of universal cystoscopy at the time of benign hysterectomy has not been associated with a significant change in the intra-operative detection and rates of LUTI at our institution.
Details
- Title
- Implementation of a policy of universal cystoscopy at the time of hysterectomy for benign indications: A retrospective comparative study
- Authors
- Xin Yu Foo (Corresponding Author) - Sunshine Coast University HospitalRachael Nugent (Author) - Sunshine Coast University Hospital
- Publication details
- Australian and New Zealand Journal of Obstetrics and Gynaecology, Vol.63(1), pp.99-104
- Publisher
- John Wiley & Sons, Inc.
- Date published
- 2023
- DOI
- 10.1111/ajo.13593
- ISSN
- 1479-828X; 0004-8666
- Copyright note
- © 2022 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Obstetricians and Gynaecologists. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
- Organisation Unit
- University of the Sunshine Coast, Queensland; School of Health and Behavioural Sciences - Legacy
- Language
- English
- Record Identifier
- 99669698902621
- Output Type
- Journal article
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- Obstetrics & Gynecology
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