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Intraoperative Ureteral Kinking During Uterosacral Ligament Suspension: Effect of Training Level on Occurrence.

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Citation: Journal of Reproductive Medicine. 61(1-2):17-21, 2016 Jan-Feb.PMID: 26995883Institution: MedStar Health Research Institute | MedStar Washington Hospital Center | MedStar Washington Hospital Center | MedStar Washington Hospital CenterDepartment: Medicine | Obstetrics and Gynecology/Female Pelvic Medicine and Reconstructive Surgery | Obstetrics and Gynecology/UrogynecologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Clinical Competence/sn [Statistics & Numerical Data] | *Gynecologic Surgical Procedures/ae [Adverse Effects] | *Intraoperative Complications/ep [Epidemiology] | *Ligaments/su [Surgery] | *Surgeons/sn [Statistics & Numerical Data] | *Uterus/su [Surgery] | Female | Humans | Retrospective StudiesYear: 2016 Local holdings: Available in print through MWHC library:1999-2007ISSN:

0024-7758

Name of journal: The Journal of reproductive medicineAbstract: CONCLUSION: Ureteral kinking occurred in 6.2% of USLS procedures at a tertiary referral center and is associated with a learning curve with statistically significant higher kinking rates among less experienced surgeons. Novel teaching methods should be considered to reduce the learning curve for this procedure.OBJECTIVE: To determine the rate of ureteral kinking during uterosacral ligament suspension (USLS) procedures at a tertiary referral center and to describe the effect of surgical training level on this occurrence. The secondary aim is to determine the mean additional anesthesia time associated with management of this complication.RESULTS: A total of 161 USLS procedures were performed during the study period; 10 had ureteral kinking (6.2%). Level of surgeon training significantly impacted ureteral kinking, with higher rates of kinking occurring among surgeons in earlier training. The occurrence of ureteral kinking during USLS significantly increased the procedure. time by a mean of 86 minutes when the surgery included vaginal hysterectomy and anterior/ posterior colporrhaphy (266.5+/-34.6 min vs. 180.1 +/-43.0 min, respectively; p=0.0078).STUDY DESIGN: This retrospective cohort study included all USLS procedures at our tertiary referral center from June 2011 to December 2013. Cases of USLS with ureteral kinking were compared to uncomplicated cases to determine the impact of surgeon training level on this occurrence.All authors: Boileau J, Iglesia CB, Janni M, Richter LA, Tefera EFiscal year: FY2016Date added to catalog: 2016-05-24

Holdings ( 1 )
Title notes ( 6 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	26995883	Available		26995883

Available in print through MWHC library:1999-2007

CONCLUSION: Ureteral kinking occurred in 6.2% of USLS procedures at a tertiary referral center and is associated with a learning curve with statistically significant higher kinking rates among less experienced surgeons. Novel teaching methods should be considered to reduce the learning curve for this procedure.

OBJECTIVE: To determine the rate of ureteral kinking during uterosacral ligament suspension (USLS) procedures at a tertiary referral center and to describe the effect of surgical training level on this occurrence. The secondary aim is to determine the mean additional anesthesia time associated with management of this complication.

RESULTS: A total of 161 USLS procedures were performed during the study period; 10 had ureteral kinking (6.2%). Level of surgeon training significantly impacted ureteral kinking, with higher rates of kinking occurring among surgeons in earlier training. The occurrence of ureteral kinking during USLS significantly increased the procedure. time by a mean of 86 minutes when the surgery included vaginal hysterectomy and anterior/ posterior colporrhaphy (266.5+/-34.6 min vs. 180.1 +/-43.0 min, respectively; p=0.0078).

STUDY DESIGN: This retrospective cohort study included all USLS procedures at our tertiary referral center from June 2011 to December 2013. Cases of USLS with ureteral kinking were compared to uncomplicated cases to determine the impact of surgeon training level on this occurrence.

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