Gn Martus, Lee Ziho, Strauss David, Eun Daniel
Lewis Katz School of Medicine at Temple University, Philadelphia, PA.
Department of Urology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA.
Urology. 2018 Mar;113:e9-e10. doi: 10.1016/j.urology.2017.12.005. Epub 2017 Dec 27.
Although iatrogenic ureteral injuries are rare, they have potentially devastating consequences for both patients and physicians, and their management remains challenging. We report a case of a 51-year-old morbidly obese (body mass index = 63) woman who suffered an iatrogenic 15-cm right ureteral avulsion during hysteroscopic biopsy. Preoperative antegrade and retrograde pyelograms demonstrated no true renal pelvis and a 3-cm blind-ending distal ureteral stump. The patient underwent a right robotic downward nephropexy, psoas hitch, lower pole calycostomy, and 11-cm appendiceal interposition. At 6 months postoperatively, renal scan demonstrated stable right renal function with no evidence of obstruction.
虽然医源性输尿管损伤很少见，但对患者和医生都可能产生极具破坏性的后果，其处理仍然具有挑战性。我们报告一例51岁病态肥胖（体重指数=63）女性病例，该患者在宫腔镜活检期间发生了15厘米的医源性右侧输尿管撕脱伤。术前顺行和逆行肾盂造影显示没有真正的肾盂，右侧输尿管远端残端呈3厘米盲端。该患者接受了右侧机器人辅助下向下肾固定术、腰大肌悬吊术、下极肾盂造口术和11厘米的阑尾间置术。术后6个月，肾脏扫描显示右侧肾功能稳定，无梗阻迹象。
