da Luz Junior P, Palou Redorta J, Iglesias Mateo J, Villavicencio Mavrich H
Servicio de Urología, Fundación Puigvert, IUNA, Barcelona, España.
Arch Esp Urol. 1992 Apr;45(3):219-21.
Transcatheter ascending pyelography is commonly performed in the post-operative evaluation of patients submitted to ileal diversion or continent bladder replacement after radical cystectomy. The present study investigated the usefulness of this procedure in the control of these patients. Of 51 patients that underwent cutaneous ileal diversion, the IVP revealed a leak of the contrast medium in only one case (1.9%). Of the 18 patients that received a continent neobladder, radiologic signs of changes were detected in 6 cases (33.3%). The complications of the IVP in our patients were fever in 26 patients (37.7%) and septicemia in one patient (1.45%). Considering the information obtained and the rate of morbility, we believe that ascending pyelography through catheters is not justified in the routine post-operative control of patients who have undergone radical cystectomy and ileal diversion. However, it appears to be a useful procedure in those cases that have undergone bladder replacement and/or continent diversion procedures.
经导管上行肾盂造影术常用于根治性膀胱切除术后接受回肠代膀胱术或可控膀胱替代术患者的术后评估。本研究探讨了该检查在这些患者管理中的实用性。在51例行皮肤回肠代膀胱术的患者中，静脉肾盂造影（IVP）仅在1例（1.9%）中显示造影剂渗漏。在18例接受可控性新膀胱术的患者中，6例（33.3%）检测到影像学改变迹象。我们患者中IVP的并发症为26例（37.7%）发热和1例（1.45%）败血症。考虑到所获得的信息和发病率，我们认为对于接受了根治性膀胱切除术和回肠代膀胱术的患者，常规术后检查中经导管上行肾盂造影术并无必要。然而，在那些接受了膀胱替代和/或可控性尿流改道术的病例中，它似乎是一种有用的检查方法。
