Laparoscopic hysterectomy in chronic renal failure patients with abnormal uterine bleeding

Abstract

Background: Chronic renal failure (CRF) in women is frequently accompanied by endocrine disturbances leading to abnormal uterine bleeding (AUB). Recurrence of AUB is the most significant problem following current treatment approaches. Laparoscopic hysterectomy (LH) might be taken into consideration for patients who no longer want to preserve their fertility; however, these patients are in high-risk groups for minimally invasive surgery. Our goal was to determine whether LH is a good option for the treatment of AUB in patients with CRF when the associated risks are carefully managed.

Material and methods: This study included five patients who underwent LH for abnormal uterine bleeding between 2013 and 2016. Enhanced perioperative management and techniques were adopted to allow LH with minimized risks to the patient.

Results: All patients underwent LH successfully, without organ failure, heavy infection or abdominal cavity bleeding during the perioperative period. Operation times ranged from 95 to 152 min (mean time 117.6 min). The mean intraoperative blood loss was 24 ml. No recurrence was observed during the 18 months follow-up period.

Conclusion: For CRF patients with AUB who no longer want to preserve their fertility, hysterectomy may be a better option, not only to permanently resolve the problem, but also to remove the risk of future uterine lesions. The improved protocols minimized the specific risks of laparoscopy arising from the patient’s coexisting medical problems, making LH a feasible treatment approach in CRF patients with AUB.

Keywords:

• Laparoscopy
• hysterectomy
• abnormal uterine bleeding
• chronic renal failure
• perioperative management

Acknowledgements

We would like to express our special thanks to Dr. Kenneth Garson, Centre for Cancer Therapeutics, Ottawa Hospital Research Institute, for proof-reading this manuscript. This work was supported by Shandong Provincial Natural Science Foundation, China (No. ZR2015HL089) and Projects of Medical and Health Technology Development Program in Shandong Province (No. 2017WS184).

Disclosure statement

No potential conflict of interest was reported by the authors.