Alizadeh Mansor, Valizadeh Rohollah, Rahimi Mohsen Mohammad
Department of Urology, Nephrology and Kidney Transplant Research Center, Urmia University of Medical Sciences, Urmia, Iran.
Department of Epidemiology, Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran.
J Surg Case Rep. 2017 Feb 28;2017(2):rjx028. doi: 10.1093/jscr/rjx028. eCollection 2017 Feb.
The patient was a 51-year-old lady with left flank colicky pain accompanied with nausea and vomiting for a month. Transurethral lithotripsy and ureteral stent placement was considered for the patient. The patient had a narrow ureteral lumen and while bringing the ureteroscope out, ureteral avulsion occurred at a distance approximately 4 cm from ureteropelvic junction. After bringing the uretroscope out, the avulsed ureter was observed hanging at the tip of the ureteroscope. Anastomosis of the ureter to the bladder was accomplished with Lich-Gregoir technique. A drainage tube was inserted at the site of incision and the surgical wound closed. The patient was discharged with acceptable general condition after 3 days and the drainage tube removed. The ureteral stent was removed 4 weeks later by cystoscopy. An ultrasound imaging study of the genitourinary system 8 months into the patients follow up showed normal size, echo and cortical thickness in the operated kidney after renal autotransplantation.
患者为一名51岁女性，左侧胁腹绞痛伴恶心、呕吐1个月。考虑为患者行经尿道碎石术及输尿管支架置入术。患者输尿管管腔狭窄，在拔出输尿管镜时，距输尿管肾盂交界处约4 cm处发生输尿管撕脱。拔出输尿管镜后，可见撕脱的输尿管悬挂在输尿管镜尖端。采用Lich-Gregoir技术完成输尿管膀胱吻合术。在切口处插入引流管，关闭手术切口。3天后患者一般情况可出院，拔除引流管。4周后经膀胱镜检查拔除输尿管支架。患者随访8个月时，对泌尿生殖系统进行超声成像检查，结果显示自体肾移植术后手术侧肾脏大小、回声及皮质厚度正常。
