Urological Complications in Total Laparoscopic Hysterectomy (TLH)

Total laparoscopic hysterectomy (TLH) is one of the most frequently performed gynecological surgery. The chapter explores urological complications in TLH. While this surgery offers benefits like reduced hospitalization and faster recovery; it presents a set of challenges. Particularly in oncological cases, due to the radical nature of surgery, bladder and ureteral injury rates range from 0.3 to 8%. Bladder injuries are more frequent than ureteral injuries, often requiring laparotomy conversion. Additionally, it may also be associated with complications such as fistulas and neurological injuries. This chapter highlights the importance of preventive measures, prompt recognition of injury, awareness of patient’s high risk factors and tailored surgical approaches to mitigate urological complications in TLH.