Turner W H, Cranston D W, Davies A H, Fellows G J, Smith J C
Department of Urology, Churchill Hospital, Headington, Oxford.
J R Soc Med. 1990 Oct;83(10):623-4. doi: 10.1177/014107689008301009.
Ureteric injury is a recognized complication of hysterectomy and may present with obstruction or fistula. Between 1987 and 1989 in Oxford nine patients with 10 injured ureters underwent attempted retrograde placement of double J stents. Three patients had successful outcomes and one patient with bilateral ureteric obstruction required reimplantation of the right ureter after successful stenting of the left ureter. One patient required removal of a stent due to irritation but her fistula eventually closed. In three patients placement was unsuccessful and in one patient injury to the bladder base prevented the ureteric orifices from being seen and hence stenting was not possible. Thus five of these 10 injured ureters were managed successfully with double J stents. We advocate the initial use of double J stents in gynaecological ureteric injury. This approach is simple and may cure the fistula. If it is unsuccessful, subsequent reimplantation is not hindered.
输尿管损伤是子宫切除术公认的并发症，可能表现为梗阻或瘘管形成。1987年至1989年期间，在牛津有9例患者共10条输尿管受损，尝试进行双J支架逆行置入。3例患者取得成功，1例双侧输尿管梗阻患者在左侧输尿管支架置入成功后，右侧输尿管需要重新植入。1例患者因刺激而需要取出支架，但她的瘘管最终闭合。3例患者支架置入未成功，1例膀胱底部损伤导致无法看到输尿管口，因此无法进行支架置入。因此，这10条受损输尿管中有5条通过双J支架成功处理。我们提倡在妇科输尿管损伤中首先使用双J支架。这种方法简单，可能治愈瘘管。如果不成功，后续的重新植入也不受影响。
