Evaluation of Strategies to Prevent Urinary Tract Injury in Minimally-Invasive Gynecologic Surgery: A Systematic Review

Abstract Objective To systematically review tools for prevention of urinary tract injury in adult women undergoing minimally-invasive gynecologic surgery Data Sources A medical librarian (M.P.H.) searched Ovid Medline 1946-, Ovid Embase 1929-, CINAHL 1965-, Cochrane Library 1974-, Web of Science 1926-, and SCOPUS 1974- on April 2-3, 2020. Methods of Study Selection Articles evaluating strategies for prevention of urinary tract injury at the time of minimally-invasive gynecologic surgery were included. Articles that were non-gynecologic, non-human, and non-adult 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 Tabulation, Integration, and Results The search yielded 2344 citations, duplicates were removed, inclusion criteria were applied, and 9 studies remained for analysis. 3 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. Results of available studies do not indicate that ureteral catheters decrease the risk of injury and indicate that they increase morbidity. Conclusion 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.