Department of Urogynecology and Pelvic Floor Disorders, Ob/Gyn & Women's Health Institute (Drs. Propst and Ridgeway).
Library Services, Floyd D. Loop Alumni Library (Ms. Harnegie), Cleveland Clinic, Cleveland, Ohio.
J Minim Invasive Gynecol. 2021 Mar;28(3):684-691.e2. doi: 10.1016/j.jmig.2020.07.020. Epub 2020 Jul 27.
To systematically review tools for the prevention of urinary tract injury in adult women undergoing minimally invasive gynecologic surgery.
A medical librarian (M.P.H.) searched Ovid Medline 1946 to, Ovid Embase 1929 to, CINAHL 1965 to, Cochrane Library 1974 to, Web of Science 1926 to, and SCOPUS 1974 to present on April 2 and April 3, 2020.
Articles evaluating strategies for the prevention of urinary tract injury at the time of minimally invasive gynecologic surgery were included. Articles that were nongynecologic, nonhuman, and nonadult were excluded. If a study did not describe the surgical approach or type of surgical procedures performed, it was excluded. If the study population was <50% gynecologic or <50% minimally invasive, it was excluded. Articles evaluating techniques for the diagnosis or management of injury, rather than prevention, were excluded.
TABULATION, INTEGRATION, AND RESULTS: The search yielded 2344 citations; duplicates were removed, inclusion criteria were applied, and 9 studies remained for analysis. Three studies evaluated bladder catheters, and 6 evaluated ureteral catheters. In the 3 studies evaluating bladder catheters, there were no urinary tract injuries. Urinary tract infection was greater in women who received a bladder catheter. In the studies evaluating the use of ureteral catheters, we found inconsistent reporting and heterogeneity that precluded meta-analysis. The results of the available studies do not indicate that ureteral catheters decrease the risk of injury, and indicate that they increase morbidity.
The evidence is insufficient to support the routine use of bladder catheters or ureteral catheters for the prevention of urinary tract injury at the time of minimally invasive gynecologic surgery.
系统回顾用于预防微创妇科手术成年女性泌尿道损伤的工具。
一名医学图书馆员（公共卫生硕士）于 2020 年 4 月 2 日和 4 月 3 日在 Ovid Medline 1946 年至、Ovid Embase 1929 年至、CINAHL 1965 年至、Cochrane Library 1974 年至、Web of Science 1926 年至和 SCOPUS 1974 年至进行检索。
纳入评估微创妇科手术时预防泌尿道损伤策略的文章。排除非妇科、非人类和非成人的文章。如果研究未描述手术方法或手术类型，则将其排除。如果研究人群中妇科手术比例<50%或微创手术比例<50%，则将其排除。排除评估损伤诊断或管理技术而非预防技术的文章。
列表、综合和结果：搜索产生了 2344 条引文；去除重复项后，应用纳入标准，有 9 项研究可供分析。有 3 项研究评估了膀胱导管，6 项研究评估了输尿管导管。在 3 项评估膀胱导管的研究中，没有泌尿道损伤。接受膀胱导管的女性发生尿路感染的风险更大。在评估输尿管导管使用的研究中，我们发现报告不一致且存在异质性，因此无法进行荟萃分析。现有研究的结果表明，输尿管导管并不能降低损伤风险，反而会增加发病率。
证据不足以支持在微创妇科手术时常规使用膀胱导管或输尿管导管预防泌尿道损伤。
