Handa V L, Maddox M D
Department of Obstetrics and Gynecology, University of California Davis School of Medicine, Sacramento 95817, USA.
Int Urogynecol J Pelvic Floor Dysfunct. 2001;12(5):345-8. doi: 10.1007/s001920170039.
Intraoperative cystoscopy has been recommended to identify unsuspected bladder and ureteral injuries resulting from gynecologic surgery. We retrospectively reviewed 157 cases of complex urogynecologic procedures at our institution. Intraoperative cystoscopy revealed no bladder injuries. Five cases of unsuspected ureteral obstruction were identified (3.2%). One case of ureteral ligation was diagnosed and repaired intraoperatively. The remaining 4 cases were found to represent chronic ureteral obstruction resulting from pelvic organ prolapse (2 cases), ureteropelvic junction obstruction (1 case) and stenosis of the ureterovesical junction after transurethral resection (1 case). Intraoperative assessment required an average of 90 minutes. Our experience suggests that pre-existing ureteral obstruction may be more common than intraoperative injury. In selected populations, routine preoperative assessment of the ureters is indicated to simplify intraoperative evaluation.
术中膀胱镜检查已被推荐用于识别妇科手术中未被怀疑的膀胱和输尿管损伤。我们回顾性分析了我院157例复杂泌尿妇科手术病例。术中膀胱镜检查未发现膀胱损伤。发现5例未被怀疑的输尿管梗阻（3.2%）。其中1例输尿管结扎在术中被诊断并修复。其余4例被发现为盆腔器官脱垂导致的慢性输尿管梗阻（2例）、肾盂输尿管连接处梗阻（1例）和经尿道切除术后输尿管膀胱连接处狭窄（1例）。术中评估平均需要90分钟。我们的经验表明，术前存在的输尿管梗阻可能比术中损伤更为常见。在特定人群中，建议进行常规术前输尿管评估，以简化术中评估。
