Lower urinary tract injury in women in the United States, 1979-2006

Objective: We sought to determine age-adjusted rates (AARs) of lower urinary tract injury and incidence in selected inpatient gynecologic and obstetric procedures. Study Design: We utilized the National Hospital Discharge Survey, 1979-2006. AARs of nonobstetric bladder and ureteral injuries and incidence of lower urinary tract injury for various hysterectomy types and deliveries were calculated for women >18 years old. Results: Overall AARs of ureteral injury decreased from 0.06-0.03 per 1000 women (1979-2006). AARs of inpatient gynecologic procedures decreased from 24.9-11.8 per 1000 women (1979-2006). By hysterectomy type, bladder injury was highest in laparoscopic-assisted vaginal hysterectomy (VH) (13.8 per 1000) and VH (13.1 per 1000). Ureteral injury recognized during hysterectomy was most common with radical hysterectomy (7.7 per 1000) and least common with laparoscopic-assisted VH (0 per 1000). Conclusion: Ureteral injuries at time of inpatient surgical procedures have decreased from 1979-2006. This corresponds with a sharp decrease in inpatient gynecologic procedures.