Evidence map›Paper›PMID 39969594›Full record

SynthesisWorld journal of urology2025

The incidence and classification of intraoperative adverse events in urological surgery: a systematic review.

Gernot Ortner, Charalampos Mavridis, Athanasios Bouchalakis, Maria Chrisoula Nakou, Yuhong Yuan, Udo Nagele, Charalampos Mamoulakis, Thomas R W Herrmann, Chandra Shekhar Biyani, Theodoros Tokas and 1 more

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Gernot OrtnerDepartment of Urology and Andrology, Hall in Tirol, General Hospital Hall I.T, Hall in Tirol, Austria.
Charalampos MavridisDepartment of Urology, Medical School, University General Hospital of Heraklion, University of Crete, Heraklion, Crete, Greece.
Athanasios BouchalakisDepartment of Urology, Medical School, University General Hospital of Heraklion, University of Crete, Heraklion, Crete, Greece.
Maria Chrisoula NakouDepartment of Urology, Medical School, University General Hospital of Heraklion, University of Crete, Heraklion, Crete, Greece.
Yuhong YuanDepartment of Medicine, London Health Science, London, ON, England.
Udo NageleDepartment of Urology and Andrology, Hall in Tirol, General Hospital Hall I.T, Hall in Tirol, Austria.
Charalampos MamoulakisDepartment of Urology, Medical School, University General Hospital of Heraklion, University of Crete, Heraklion, Crete, Greece.
Thomas R W HerrmannHall in Tirol, Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria.
Chandra Shekhar BiyaniSt James's University Hospital, Leeds, UK.
Theodoros TokasHall in Tirol, Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group, Hall in Tirol, Austria.
Mithun KailavasanVictoria Hospital, University of Western Ontario, London, ON, Canada. Mithun.kailavasan@doctors.org.uk.ORCID https://orcid.org/0000-0002-5595-3541

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo perform a systematic review (SR) to examine the application of classification systems (CS) used to report intraoperative adverse events (iAEs) in urological surgery and to evaluate the crude incidence and type of iAEs. MATERIALS AND

methodsThis review was published via PROSPERO (CRD42024549954) and conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). MEDLINE, Embase, and the Cochrane CENTRAL were searched using a predefined PICO framework: (P) patients with benign and malignant urological diseases, (I) all types of urological surgery, (C) none/any, (O) intraoperative complications classified with grading systems. Retrospective and prospective studies published between January 2019 and June 2024 were included.

resultsThe search yielded 1,570 abstracts, 1,043 full-text articles were assessed for eligibility, of which 325 studies reported iAEs (54 used iAE-CS, 64 used Clavien-Dindo Classification and 207 used free-text descriptions). Of the 54 studies (15,298 patients) that used an iAE-CS, the three most used systems were the EAUiaiC (54%), SATAVA (26%), and the modified SATAVA (7%). The overall incidence of iAE was 14% (2,153/15,225 patients). On a study level, the crude incidence of iAE was between 0 and 100% (median 7%, IQR: 3-13%). The misapplication of the Clavien-Dindo system to describe iAEs was high (n = 64 studies).

conclusionsThe use of iAE-CS is scarce, and there is a lack of universal consensus on a CS to describe iAEs. iAE are poorly reported in urological studies. Urologists should report all perioperative complications to improve transparency and surgical and hospital processes.

Indexed as

Intraoperative ComplicationsUrologic Surgical ProceduresHumansIncidenceClassificationComplicationsIntraoperative complicationsPerioperativeRisk ManagementUrologic Surgical procedures

Identifiers

PMID39969594

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.