E-Posters-10202_Florian

10202_Florian_Rodriguez

Pdf Summary

Lower urinary tract fistulas are a rare complication after major pelvic surgery, with hysterectomy being the most common procedure associated with these fistulas in the United States. The incidence of urogenital fistulas after benign hysterectomy is less than 0.5% and can be as high as 10% after radical hysterectomy. Several risk factors have been identified, including lower urinary tract injury during the surgery, route of hysterectomy, malignancy, radiation therapy, prior surgery, pelvic inflammatory disease, diabetes, chronic steroid use, tobacco use, and perioperative hematoma or infection. However, large cohorts and population-based incidence estimates are needed to confirm these risk factors.<br /><br />This study analyzed data from the National Surgery Quality Improvement Program Database to determine the incidence and risk factors associated with lower urinary tract fistulas after hysterectomy. The study included 42,643 women who underwent hysterectomy, with a mean age of 46.1 years for those who developed a fistula and 50.1 years for those who did not. The overall incidence of lower urinary tract fistulas in this cohort was 0.11%, with most cases being uretero-vaginal fistulas. The incidence varied slightly depending on the route of hysterectomy.<br /><br />The study identified younger age and chronic steroid use as significant risk factors for fistula development within 30 days of hysterectomy. Patients who developed a fistula commonly experienced progressive renal insufficiency, and more than half of them returned to the operating room within 30 days of the procedure.<br /><br />These findings suggest that lower urinary tract fistulas after hysterectomy are rare, but younger age and chronic steroid use are significant risk factors for their development. However, further research is needed to confirm these findings and determine the incidence and risk factors on a population level.

Keywords

lower urinary tract fistulas

major pelvic surgery

hysterectomy

urogenital fistulas

incidence

risk factors

benign hysterectomy

radical hysterectomy

lower urinary tract injury

route of hysterectomy