J Minim Invasive Gynecol. 2012 Jul-Aug;19(4):407-11. doi: 10.1016/j.jmig.2012.05.001.
Lower urinary tract injuries are a serious potential complication of laparoscopic hysterectomy. The risk of such injuries may be as high as 3%, and most, but not all, are detected at intraoperative cystoscopy. High-quality published data suggest a sensitivity of 80% to 90% for ureteral trauma. Among the injuries that may be missed are those related to the use of energy-based surgical tools that include ultrasound and radiofrequency electricity. Cystoscopic evaluation of the lower urinary tract should be readily available to gynecologic surgeons performing laparoscopic hysterectomy. To this end, it is essential that a surgeon with appropriate education, training, and institutional privileges be available without delay to perform this task. Currently available evidence supports cystoscopy at the time of laparoscopic hysterectomies. The rate of detectable but unsuspected lower urinary tract injuries is enough to suggest that surgeons consider cystoscopic evaluation following laparoscopic total hysterectomy as a routine procedure.
下尿路损伤是腹腔镜子宫切除术的严重潜在并发症。此类损伤的风险可能高达 3%，大多数（但并非全部）在术中膀胱镜检查时发现。高质量的已发表数据表明，输尿管损伤的敏感性为 80%至 90%。可能被遗漏的损伤包括与使用超声和射频电等能量外科工具相关的损伤。进行腹腔镜子宫切除术的妇科外科医生应随时准备好进行下尿路的膀胱镜评估。为此，必须有经过适当教育、培训和机构特权的外科医生能够及时执行此任务。目前可用的证据支持在腹腔镜子宫切除术时进行膀胱镜检查。可检测但未被怀疑的下尿路损伤的发生率足以表明，外科医生应考虑在腹腔镜全子宫切除术后将膀胱镜检查作为常规程序。
