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目的探讨输尿管镜技术治疗早期输尿管阴道瘘的治疗方法和效果。方法 2005—2011年共收治8例妇科手术致输尿管阴道瘘患者,通过病史采集、体格检查、超声、美蓝试验、静脉尿路造影(IVU)、膀胱镜检查和泌尿系CTU检查确诊,将术中输尿管结扎患者予以排除,明确诊断为输尿管阴道瘘后即行手术治疗。研究组患者全部采用连续硬膜外麻醉下经尿道输尿管镜下留置双J管治疗。3个月后门诊拔除双J管。结果本组8例患者,术后第一天阴道漏尿明显减少,第五天后漏尿均消失。留置双J管3个月后于门诊经尿道输尿管镜取出,术后均获得治愈。随访6~12个月,B超复查未发现患肾扩张及积水,所有患者均无尿瘘复发,输尿管未产生狭窄。结论早期采用经输尿管镜留置双J管治疗输尿管阴道瘘是适宜的。输尿管镜技术下放置双J管为处理输尿管阴道瘘的首选治疗方式。
Objective To investigate the treatment of ureteroscopic treatment of early ureteroscopic fistula and its effect. Methods A total of 8 patients with ureteroscopic fistulas undergone gynecological surgery were enrolled in this study from 2005 to 2011. The patients were diagnosed by history collection, physical examination, ultrasound, methylene blue test, intravenous urography (UUVI), cystoscopy and urological CTU. In patients with ureteral ligation to be excluded, a clear diagnosis of ureteral fistula surgery after surgery. All patients in the study group were treated with transurethral ureteroscopic double J tube under continuous epidural anesthesia. 3 months after the double-J tube removal. Results 8 patients in this group, the first day after surgery significantly reduced vaginal leakage, leakage of urine after the fifth day disappeared. After three months of indwelling double J tube in the clinic by urethral ureter removed, were cured after surgery. Follow-up 6 to 12 months, B-ultrasound did not find renal distension and water, all patients had no recurrence of urinary fistula, ureter did not produce stenosis. Conclusion The early use of ureteroscopic double J tube ureteral fistula is appropriate. Ureteroscopy placed double J tube ureter fistula treatment for the treatment of choice.