Recommendations to Prevent Urinary Tract Injuries During Laparoscopic Hysterectomy: A Systematic Delphi Procedure Among Experts

Study objectiveTo reach consensus among experts in the field of laparoscopic gynaecology in uniform recommendations on the prevention and early detection of urinary tract injuries during laparoscopic hysterectomy (LH).DesignA systematic Delphi consensus procedure (Canadian Task Force Classification III).SettingA tertiary-care university hospital.PopulationInternational gynecologic experts in the field of LH.MethodsExperts were selected according to standard criteria with regard to surgical experience and research. Twenty of 40 experts were willing to participate. Three questionnaires were sent. Each questionnaire was formulated and based on the answers of the previous one.ResultsFourteen experts completed the third questionnaire. In 40 of 65 proposed recommendations, consensus was achieved. Consensus was achieved with respect to required education, learning curve, equipment, restoration of distorted anatomy and on the application of diagnostic tools in early detection of urinary tract injuries.ConclusionThe Delphi technique is a useful tool to achieve consensus regarding urologic complications in LH. Recommendations may serve as a basis for further research and the development of educational programs.