Abstract
Pelvic reconstructive surgery is not devoid of complications, some minor and some more serious. This chapter covers the most common injuries ranging from positioning nerve damage to bladder, ureteral, rectal, or urethral injury. A movie on the vaginal repair of a bladder injury during a laparoscopic vaginal hysterectomy illustrates some of the key steps to achieve a complete repair. The vaginal surgeon should be attentive to pre-existing factors that may place the patient at risk and have a game plan to deal with any complications should they arise.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Lambrou NC, Buller JL, Thompson JR, et al. Prevalence of perioperative complications among women undergoing reconstructive pelvic surgery. Am J Obstet Gynecol. 2000;183:1355.
Mann WJ, Arato M, Patsner B, et al. Ureteral injuries in an obstetrics and gynecology training program: etiology and management. Obstet Gynecol. 1988;72:82.
Lee RA, Symmonds RE, Williams TJ. Current status of genitourinary fistula. Obstet Gynecol. 1988;72:313.
Mathevet P, Valencia P, Cousin C, et al. Operative injuries during vaginal hysterectomy. Eur J Obstet Gynecol Reprod Biol. 2001;97:71.
Handa VL, Harvey L, Cundiff GW, et al. Perioperative complications of surgery for genital prolapse: does concomitant anti-incontinence surgery increase complications? Urology. 2005;65:483.
Vaislic CD, Dalibon N, Ponzio O, et al. Outcomes in cardiac surgery in 500 consecutive Jehovah’s Witness patients: 21 year experience. J Cardiothorac Surg. 2012;7:95.
Trzcinski R, Kujawski R, Mik M, et al. Surgery in Jehovah’s Witnesses – our experience. Prz Gastroenterol. 2015;10:33.
Goldman HB. Complications of Female Incontinence and Pelvic Reconstructive Surgery. New York: Springer Science & Business Media; 2012.
Wolf Jr JS, Bennett CJ, Dmochowski RR, et al. Best practice policy statement on urologic surgery antimicrobial prophylaxis. J Urol. 2008;179:1379.
Kjolhede P, Halili S, Lofgren M. The influence of preoperative vaginal cleansing on postoperative infectious morbidity in abdominal total hysterectomy for benign indications. Acta Obstet Gynecol Scand. 2009;88:408.
Kjolhede P, Halili S, Lofgren M. Vaginal cleansing and postoperative infectious morbidity in vaginal hysterectomy. A register study from the Swedish National Register for Gynecological Surgery. Acta Obstet Gynecol Scand. 2011;90:63.
Ballard RM, Bradley-Watson PJ, Johnstone FD, et al. Low doses of subcutaneous heparin in the prevention of deep vein thrombosis after gynaecological surgery. J Obstet Gynaecol Br Commonw. 1973;80:469.
Tulikangas PK, Weber AM, Larive AB, et al. Intraoperative cystoscopy in conjunction with anti-incontinence surgery. Obstet Gynecol. 2000;95:794.
Katske FA, Raz S. Use of Foley catheter to obtain transvaginal tamponade. Urology. 1987;18.
Anger JT, Weinberg AE, Gore JL, et al. Thromboembolic complications of sling surgery for stress urinary incontinence among female Medicare beneficiaries. Urology. 2009;74:1223.
Solomon ER, Frick AC, Paraiso MF, et al. Risk of deep venous thrombosis and pulmonary embolism in urogynecologic surgical patients. Am J Obstet Gynecol. 2010;203:510 e1.
Maxwell GL, Synan I, Dodge R, et al. Pneumatic compression versus low molecular weight heparin in gynecologic oncology surgery: a randomized trial. Obstet Gynecol. 2001;98:989.
Staskin DR, Hadley HR, Zimmern P, et al. Preoperative, intraoperative, and postoperative management of vaginal surgery. Semin Urol. 1986;4:7.
Elard S, Cicco A, Salomon L, et al. Embolization for arterial injury incurred during tension-free vaginal tape procedure. J Urol. 2002;168:1503.
Otton GR, Mandapati S, Streatfeild KA, et al. Transfusion rate associated with hysterectomy for benign disease. Aust N Z J Obstet Gynaecol. 2001;41:439.
Stanford EJ, Paraiso MF. A comprehensive review of suburethral sling procedure complications. J Minim Invasive Gynecol. 2008;15:132.
Ford AA, Rogerson L, Cody JD, et al. Mid-urethral sling operations for stress urinary incontinence in women. Cochrane Database Syst Rev. 2015;(7):CD006375.
Aungst M, Wagner M. Foley balloon to tamponade bleeding in the retropubic space. Obstet Gynecol. 2003;102:1037.
Kuuva N, Nilsson CG. A nationwide analysis of complications associated with the tension-free vaginal tape (TVT) procedure. Acta Obstet Gynecol Scand. 2002;81:72.
Zilbert AW, Farrell SA. External iliac artery laceration during tension-free vaginal tape procedure. Int Urogynecol J Pelvic Floor Dysfunct. 2001;12:141.
McLennan MT, Barr SA, Melick CF, et al. Bladder perforation during tension-free vaginal tape procedures: abdominal versus vaginal approach. Female Pelvic Med Reconstr Surg. 2012;18:25.
Boustead GB. The tension-free vaginal tape for treating female stress urinary incontinence. BJU Int. 2002;89:687.
Dmochowski RR, Blaivas JM, Gormley EA, et al. Update of AUA guideline on the surgical management of female stress urinary incontinence. J Urol. 2010;183:1906.
Andonian S, Chen T, St-Denis B, et al. Randomized clinical trial comparing suprapubic arch sling (SPARC) and tension-free vaginal tape (TVT): one-year results. Eur Urol. 2005;47:537.
Hilton P, Rose K. The “learning curve” for retropubic mid-urethral sling procedures: a retrospective cohort study. Int Urogynecol J. 2016;27:565.
Maher C, Feiner B, Baessler K, et al. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2013;(4): CD004014.
Lavelle RS, Christie AL, Alhalabi F, et al. Risk of prolapse recurrence after native tissue anterior vaginal suspension procedure with intermediate to long-term followup. J Urol. 2015; 195(4P1):1014–20.
Guerriero WG. Operative injury to the lower urinary tract. Clin Obstet Gynaecol. 1985;12:465.
Kursh ED, Morse RM, Resnick MI, et al. Prevention of the development of a vesicovaginal fistula. Surg Gynecol Obstet. 1988;166:409.
Hernandez RD, Himsl K, Zimmern PE. Transvaginal repair of bladder injury during vaginal hysterectomy. J Urol. 1994;152:2061.
Wang Y, Hadley HR. The use of rotated vascularized pedicle flaps for complex transvaginal procedures. J Urol. 1993;149:590.
Doyle PJ, Lipetskaia L, Duecy E, et al. Sodium fluorescein use during intraoperative cystoscopy. Obstet Gynecol. 2015;125:548.
Stanhope CR, Wilson TO, Utz WJ, et al. Suture entrapment and secondary ureteral obstruction. Am J Obstet Gynecol. 1991;164:1513.
Turner LC, Lavelle ES, Shepherd JP. Comparison of complications and prolapse recurrence between laparoscopic and vaginal uterosacral ligament suspension for the treatment of vaginal prolapse. Int Urogynecol J. 2015; 27(5):797–803.
Barber MD, Brubaker L, Burgio KL, et al. Comparison of 2 transvaginal surgical approaches and perioperative behavioral therapy for apical vaginal prolapse: the OPTIMAL randomized trial. JAMA. 2014;311:1023.
Visco AG, Taber KH, Weidner AC, et al. Cost-effectiveness of universal cystoscopy to identify ureteral injury at hysterectomy. Obstet Gynecol. 2001;97:685.
Brandes S, Coburn M, Armenakas N, et al. Diagnosis and management of ureteric injury: an evidence-based analysis. BJU Int. 2004;94:277.
Pettit PD, Petrou SP. The value of cystoscopy in major vaginal surgery. Obstet Gynecol. 1994;84:318.
Harris RL, Cundiff GW, Theofrastous JP, et al. The value of intraoperative cystoscopy in urogynecologic and reconstructive pelvic surgery. Am J Obstet Gynecol. 1997;177:1367.
Gilmour DT, Dwyer PL, Carey MP. Lower urinary tract injury during gynecologic surgery and its detection by intraoperative cystoscopy. Obstet Gynecol. 1999;94:883.
Kasyan G, Abramyan K, Popov AA, et al. Mesh-related and intraoperative complications of pelvic organ prolapse repair. Cent Eur J Urol. 2014;67:296.
Daneshgari F, Kong W, Swartz M. Complications of mid urethral slings: important outcomes for future clinical trials. J Urol. 2008;180:1890.
Hoffman MS, Lynch C, Lockhart J, et al. Injury of the rectum during vaginal surgery. Am J Obstet Gynecol. 1999;181:274.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Electronic Supplementary Material
Below is the link to the electronic supplementary material.
Repair of bladder injury during laparoscopic assisted vaginal hysterectomy (MP4 42383 kb)
(MP4 71000 kb)
Rights and permissions
Copyright information
© 2017 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Belsante, M.J., Zimmern, P.E. (2017). Intraoperative Complications of Vaginal Surgery. In: Zimmern, P., De, E. (eds) Native Tissue Repair for Incontinence and Prolapse. Springer, Cham. https://doi.org/10.1007/978-3-319-45268-5_19
Download citation
DOI: https://doi.org/10.1007/978-3-319-45268-5_19
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-45266-1
Online ISBN: 978-3-319-45268-5
eBook Packages: MedicineMedicine (R0)