Lusuardi Lukas, Hruby Stephan, Jeschke Stephan, Zimmermann Reinhold, Sieberer Manuela, Janetschek Günther
Department of Urology and Andrology, Paracelsus Medical University Salzburg, Salzburg, Austria. L.Lusuardi @ salk.at
Urol Int. 2011;87(3):260-2. doi: 10.1159/000328390. Epub 2011 Aug 26.
Retrograde ureteral access after cross-trigonal ureteral reimplantation can be challenging. We present our experience with retrograde ureteral catheterization and flexible ureteroscopy after Cohen cross-trigonal reimplantation in patients presenting with ureteral stones.
Cystoscopy is performed and a Tiemann ureteral catheter is inserted into the involved ureteral orifice. A retrograde ureterography is performed and hydrophilic guide wire is passed up to the kidney. A dual-lumen ureteral access sheath is then passed under x-ray control underneath the ureteral stone. The flexible ureterorenoscope is passed under x-ray control up to the stone which is then fragmented with a holmium laser.
From June 2006 to June 2010, this technique was successful in 8 patients without acute or delayed sequelae.
Where the endourological expertise is readily available, the ureter can be accessed retrogradely even after Cohen cross-trigonal ureteral reimplantation in a safe, straightforward and effective modality.
经三角区输尿管再植术后逆行输尿管通路建立具有挑战性。我们介绍了在输尿管结石患者中，经科恩三角区再植术后进行逆行输尿管插管和软性输尿管镜检查的经验。
进行膀胱镜检查，将蒂曼输尿管导管插入患侧输尿管口。进行逆行输尿管造影，并将亲水导丝向上送入肾脏。然后在X线控制下，将双腔输尿管通路鞘置于输尿管结石下方。在X线控制下将软性输尿管肾镜送入至结石处，然后用钬激光将结石粉碎。
2006年6月至2010年6月，该技术在8例患者中取得成功，无急性或延迟性后遗症。
在内镜技术成熟的情况下，即使是在经科恩三角区输尿管再植术后，也能够以安全、直接且有效的方式逆行进入输尿管。
