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International Urogynecology Journal

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01-12-2015 | Original Article

Risk factors for ureteral occlusion during transvaginal uterosacral ligament suspension

Authors: Elisha Jackson, Jorge A. Bilbao, Robert W. Vera, Zuber D. Mulla, Veronica T. Mallett, T. Ignacio Montoya

Published in: International Urogynecology Journal | Issue 12/2015

Abstract

Introduction and hypothesis

To determine any risk factors associated with ureteral occlusion during transvaginal uterosacral ligament suspension (USLS).

Methods

A retrospective query to identify patients that underwent transvaginal USLS at a teaching hospital from 2008 to 2013 was performed. Patients in which ureteral occlusion was identified by cystoscopy were identified (cases), and compared with those without occlusion (controls). Medical records were reviewed for data abstraction. Variables compared between cases and controls included demographics, medical history/examination, concomitant procedures, number of suspension sutures placed, estimated blood loss and length of hospital stay. Univariate analyses were performed to identify potential risk factors for ureteral occlusion, followed by multivariate regression analysis to estimate odds ratios for identified predictors.

Results

A total of 144 USLS procedures were performed. Thirteen cases of ureteral occlusion were identified (9%). Baseline prolapse stage, body mass index, parity, previous hysterectomy or pelvic surgery of the groups were similar (all P > 0.05). Univariate analysis identified age (P = 0.04), concomitant anterior colporrhaphy (P = 0.01), and use of a suture-capturing device for suture placement (P = 0.04) as significant factors. On multivariate logistic regression analysis, concomitant anterior colporrhaphy increased ureteral occlusion risk (OR 10.5, 95%CI 2.37–74.99, P = 0.001), while use of a suture-capturing device decreased it (OR 0.1, 95%CI 0–0.41, P = 0.01). The mean number of suspension sutures placed per side was similar in the two groups (2.6 [range 2–4] for cases and 2.4 [range 1–4] for controls, P = 0.15).

Conclusions

During transvaginal USLS, performance of a concomitant anterior colporrhaphy increased the risk of ureteral occlusion, while the use of a suture-capturing device for suspension suture placement was associated with decreased risk.

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Title: Risk factors for ureteral occlusion during transvaginal uterosacral ligament suspension
Authors: Elisha Jackson
Jorge A. Bilbao
Robert W. Vera
Zuber D. Mulla
Veronica T. Mallett
T. Ignacio Montoya
Publication date: 01-12-2015
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 12/2015
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-015-2770-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Risk factors for ureteral occlusion during transvaginal uterosacral ligament suspension

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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