Published online Mar 20, 2023. doi: 10.5662/wjm.v13.i2.18
Peer-review started: October 30, 2022
First decision: January 20, 2023
Revised: February 2, 2023
Accepted: February 13, 2023
Article in press: February 13, 2023
Published online: March 20, 2023
Ureteral injury is a known complication of hysterectomies. Recent studies have attempted to correlate surgeon volume and experience with incidence of urinary tract injuries during hysterectomies. Some studies have reported that as surgeon volume increases, urinary tract injury rates decrease. To our knowledge, no studies have assessed the relationship between surgeon subspecialty and the rate of urinary tract injury rates during minimally invasive hysterectomy.
To determine the incidence of urinary tract injury between urogynecologists, gynecologic oncologists, and general gynecologists.
The study took place from January 1, 2016 to December 1, 2021 at a large comm
Urologic injury occurred in four patients (2%) in the general gynecologist group, in one patient (1%) in the gynecologic oncologist group, and in one patient (1%) in the urogynecologist group. When comparing high and low-volume surgeons, there was no statistically significant difference in urinary tract injury (1% vs 2%) or bowel injury (1% vs 0%). There were more complications in the low-volume group vs the high-volume group excluding urinary tract, bowel, or major vessel injury. High-volume surgeons had four (1%) patients with a complication and low-volume surgeons had 12 (4%) patients with a complication (P = 0.04).
Our study demonstrated that there was no difference in the urinary tract injury rate in general gynecologists vs subspecialists, however our study was underpowered.
Core Tip: Surgeon volume and experience have been shown to play a role in decreasing the number of urinary tract injuries during minimally invasive hysterectomies. One may conclude that since urogynecologists and gynecologic oncologists had additional training years after residency, they also have more experience. This may result in a decreased incidence of urinary tract injury during minimally invasive hysterectomies. To our knowledge, no studies to date have been done to assess this correlation.