Prophylactic ureteral catheterization in gynecologic surgery: a 12-year randomized trial in a community hospital

Introduction  The aim of this study is to determine the efficacy of preoperative ureteral catheterization as a prophylactic measure to prevent ureteral injury and related complications. Methods  All major gynecologic operations performed between January 1996 and December 2007 were included and prospectively randomized into with and without catheterization groups. The medical records allowed the identification of all urinary tract complications and ureteral injuries. Results  Bilateral prophylactic ureteral catheterization was performed in 1,583 patients. A ureteral injury occurred in 19 (1.20%) out of 1,583 patients. Seventeen ureteral injuries (1.09%) occurred out of 1,558 patients without prophylactic ureteral catheterization. There was no statistically significant difference in the incidence of ureteral injury between the different interventional groups (p = 0.774). Conclusion  The use of prophylactic ureteral catheters did not eliminate ureteral injuries in our patients. The presence of ureteral catheters should not supplant meticulous surgical techniques and direct visualization of the ureters during gynecologic surgery.