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目的:总结输尿管子宫内膜异位症的临床、病理特点及采用不同手术方法治疗的效果。方法:回顾分析6例输尿管子宫内膜异位症患者的临床资料、术后随访资料,并对这些结果进行对比分析。结果:6例患者均为单侧发病、均为下1/3段,3例术前病理确诊,行病变段切除、输尿管膀胱再植术,术后随访1～5年,均无复发梗阻;另外3例术前未确诊,行病变段冷刀内切开+双重双J管内引流2～3个月,拔管后随访过程中,1例失访,另外2例分别于6和11个月复发梗阻,改为病变段切除、输尿管膀胱再植术,再随访1～3年,未发现复发梗阻。6例术后2周始均结合药物内分泌治疗3～6个月,其中3例口服丹那唑0.2g Bid,3例皮下注射康士得3.6mg 1次/月。结论:输尿管镜下冷刀内切开虽然创伤较小,但不能完全去除异位的子宫内膜,梗阻复发率较高,故临床上以采用病变段切除、输尿管膀胱再植术,结合内分泌治疗为妥。
Objective: To summarize the clinical and pathological features of ureter endometriosis and the effects of different surgical methods. Methods: Retrospective analysis of 6 cases of ureteral endometriosis in patients with clinical data, follow-up data, and comparative analysis of these results. Results: All the 6 patients were unilateral disease, all of them were in the lower third. Three cases were diagnosed preoperatively, and the lesions were resected and the ureter was replanted. No recurrence was observed after 1 to 5 years of follow - up. The other 3 cases were not diagnosed preoperatively, the lesion within the cold knife incision + double double J tube drainage for 2 to 3 months, follow-up after extubation, 1 case was lost, the other 2 cases were 6 and 11 months Recurrence of obstruction, to the lesion resection, ureter bladder replantation, and then follow-up 1 to 3 years, no recurrence was found. 6 patients were treated with endocrine therapy for 3 to 6 months after operation, 3 of which were treated with 0.3g of danazol, and 3 of them were given Constantia 3.6mg once a month. Conclusions: Ureteroscopic cold knife incision, although less traumatic, but can not completely remove the ectopic endometrium, obstruction recurrence rate is high, so the clinical use of segmental resection, ureter bladder replantation, combined with endocrine therapy To be proper.