August 29th, 2014

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Title:
A Note from the Editor-in-Chief
Authors:  Lawrence D. Devoe, M.D.
  Welcome to the September-October 2011 Editor-in-Chief’s page. In this issue I will focus on two articles related to important areas in clinical obstetrics and gynecology.
In This Issue:
• Cystoscopy Should Be a Routine Procedure in the Performance of Hysterectomy (Editorial)
R. R. Chesson
After cesarean delivery, hysterectomy by a variety of routes and techniques is one of the most common major surgical procedures for women in the United States. Most hysterectomies are performed to treat benign disease, but they confer risk for significant urinary tract injuries. Patient safety, including timely recognition of ureteral or bladder injuries, has become a dominant theme in new millennium medical practice. Fortunately, such injuries are relatively uncommon; however, they can have long-term and devastating effects on patient health if not addressed at the time that they occur. The ACOG Committee Opinion, cited by the author, does not recommend the routine use of cystoscopy during or following hysterectomy due to lack of evidence-based studies. Although this is technically true, I think that Ibeanu et al (Reference 1 of the Editorial) sound a cautionary but clear note for gynecologists, both in training and in practice: urinary tract injury may be more common than previously believed. For both good and bad reasons, it usually takes years for clinical practice patterns to change, even after there is compelling evidence to do so. Will cystoscopy become a “routine” adjunctive procedure for all hysterectomies, as Dr. Chesson advocates? If this message gets out to more and more clinicians, it just might happen.
 
   
   
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