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Comparative Study
. 2021 Apr 1;27(4):260-263.
doi: 10.1097/SPV.0000000000000800.

Impact of Cystotomy Location on Cystography Results

Gnankang Sarah Napoe  1 , Lauren E Stewart, Deborah L Myers
Affiliations
Comparative Study

Impact of Cystotomy Location on Cystography Results

Gnankang Sarah Napoe et al. Female Pelvic Med Reconstr Surg. .

Abstract

Objectives: This study aimed to determine if the location of a repaired bladder injury (trigone vs dome) impacts the probability of an abnormal cystography result in obstetric/gynecologic surgical patients undergoing repair of an unanticipated cystotomy.

Methods: We conducted a retrospective review of adult obstetric and gynecologic surgical patients who underwent cystographic evaluation of bladder integrity after repair of iatrogenic cystotomy at a single institution between January 2006 and July 2018. We excluded patients who had undergone repair of genitourinary fistula or urethral diverticulum. Patients were dichotomized into 2 groups based on the location of the repaired bladder injury: trigone versus dome. Fisher exact and Student t tests were used to determine the proportion of abnormal cystogram results and factors associated with an abnormal cystography result.

Results: Two hundred ten cases met the inclusion criteria: 176 in the dome group and 34 in the trigone group. When comparing the dome and trigone groups, respectively, mean age (45.2 ± 12.5 vs 48.4 ± 11.2 years) and cystotomy size (3.2 ± 3.2 vs 2.2 ± 2.4 cm) were comparable. Duration of postoperative bladder catheterization was longer in the trigone group (13.7 vs 12.1 days, P = 0.03). Despite the additional bladder drainage, there were more abnormal cystogram results in the trigone group versus the dome (8.8% vs 1.1%; odds ratio, 8.4).

Conclusions: A repaired cystotomy at the trigone is associated with increased odds of an abnormal cystography result. An abnormal cystography result after repair at the bladder dome is rare.

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Conflict of interest statement

G.S.N. and L.E.S. have declared that there are no conflicts of interest. D.L.M. has grant support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and is a consultant for Ocean Spray.

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