Clinical analysis of iatrogenic ureteral injury and bladder injury
10.3760/cma.j.issn.1000-6702.2010.02.008
- VernacularTitle:医原性输尿管膀胱损伤诊治分析
- Author:
Dapang RAO
;
Haifeng YU
;
Xinde LI
;
Yuebing CHEN
;
Haibo ZHU
;
Yinghe CHEN
;
Youhun HE
;
Zhenchuan CHEN
- Publication Type:Journal Article
- Keywords:
latrogenic diseases;
Ureteral injury;
Bladder injury
- From:
Chinese Journal of Urology
2010;31(2):96-98
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the etiology and treatment of iatrogenic ureteral injury(IUI) and bladder injury(IBI). Methods Forty-seven patients(7 males, 40 females) with ureteral and bladder inju-ries caused as a result of any medical procedures were reviewed from 1996 to 2007. Obstetrics and gynecolog-ical, urological,general surgical procedures were involved in 38, 6, and 4 of the injuries respectively. Re-sults Sixteen cases of IUI were found during operation, including 14 cases of entire ureteral laceration, 4 cases of partial ureteral laceration. Thirteen cases received ureteral anastomosis, one case received uretero-neopyelostomy. One case of ureteral perforations during ureteroscopic procedure was indweUed of double-J after the operation was terminated immediately. Three cases received nephrectomy. Four cases of lower ure-teric suture ligation and three cases of ureterovaginal fistula were detected at 3 days～ one week of postopera-tion. These 7 cases were received ureteroneocystomy during 2 weeks after the initial surgical procedure. Nineteen cases of IBI were found during operation, the length of cystic wound was ranging from 1 cm to 3 cm. 17 cases underwent repairing, 2 eases of bladder perforation which caused by endourologic or TVT procedure received catheterization for 1 week. Five cases of vesicovaginal fistula which were found during one week--one month of post-operation, were received fistula resection and bladder repairing 3 months after of initial operation. Forty-seven cases were follow-up ranging from 5 months to 11 years after the second opera-tion,mean time were 47 months. All cases were recovered. Conclusions Intraoperative findings and effec-tive treatments can achieve good therapeutic effects and avoid injury during secondary operation. Correct treatment of urinary fistula can promote cure rate.
