Department of Urology, Parana Federal University, Curitiba, Brazil.
J Endourol. 2010 Nov;24(11):1817-20. doi: 10.1089/end.2010.0075. Epub 2010 Sep 21.
Fibrotic or neoplastic obstruction of the terminal ureter and ureterovesical junction can preclude internal drainage with a Double-J catheter. Some minimally invasive alternatives are described in the literature to avoid a percutaneous nephrostomy. We present a pure endourologic technique.
In six patients with an obstructed upper urinary tract, after the introduction of iodine contrast, the ureter was punctured with a needle to introduce a guidewire in the urinary tract under cystoscopic and fluoroscopic control. The alternative path between the bladder and ureter was then dilated up 10F to facilitate the Double-J catheter introduction.
All six patients had their obstructed urinary tract drained with a Double-J catheter inserted above the level of obstruction. No complication was verified.
Internal urinary tract drainage with a Double-J catheter was accomplished using endourologic principles in six patients, avoiding a percutaneous nephrostomy or other more invasive procedures.
纤维性或肿瘤性终末输尿管和输尿管膀胱连接部梗阻可使双 J 导管无法进行内引流。文献中描述了一些微创替代方法以避免经皮肾造口术。我们介绍一种纯内镜技术。
在 6 例上尿路梗阻患者中，在引入碘造影剂后，经针穿刺输尿管，在膀胱镜和透视控制下将导丝引入尿路。然后将膀胱和输尿管之间的替代路径扩张至 10F 以方便双 J 导管的引入。
所有 6 例患者均通过在梗阻上方插入双 J 导管成功引流其梗阻性尿路。未发现并发症。
在 6 例患者中，使用内镜技术的原则成功进行了双 J 导管的尿路内引流，避免了经皮肾造口术或其他更具侵袭性的操作。
