Ledderose S, Beck V, Chaloupka M, Kretschmer A, Strittmatter F, Tritschler S
Urologische Klinik und Poliklinik, Klinikum Großhadern, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, München, Deutschland.
Klinik für Urologie und Urologische Onkologie, Loretto-Krankenhaus, RKK-Klinikum Freiburg, Freiburg, Deutschland.
Urologe A. 2019 Feb;58(2):197-206. doi: 10.1007/s00120-019-0864-y.
Ureteral injuries account for less than 3% of genitourinary injuries. Most of them are caused iatrogenically during abdominal surgery. The symptoms are often non-specific and do not aid in diagnosis. The later the injury is detected, the more often complications occur. Therefore, in such situations it is important to consider the possibility of ureteral injury and initiate further diagnostic steps as soon as possible. A variety of diagnostic tests are available. In addition to the direct inspection of the ureters and retrograde ureteropyelography, computed tomography (CT) urography is routinely used. Based on the time of diagnosis as well as the extent and the localization of the injury, the further procedure can be determined. For minor injuries, the insertion of a ureteral splint is usually the treatment of choice. In the case of higher grade damage, operative reconstruction by one of several possible surgical procedures is indicated.
输尿管损伤占泌尿生殖系统损伤的比例不到3%。其中大多数是腹部手术过程中由医源性因素导致的。其症状往往不具有特异性,对诊断没有帮助。损伤发现得越晚,并发症出现的频率就越高。因此,在这种情况下,考虑输尿管损伤的可能性并尽快启动进一步的诊断步骤很重要。有多种诊断测试可供使用。除了直接检查输尿管和逆行输尿管肾盂造影外,计算机断层扫描(CT)尿路造影也被常规使用。根据诊断时间以及损伤的程度和部位,可以确定进一步的治疗方案。对于轻度损伤,插入输尿管支架通常是首选治疗方法。对于较严重的损伤,则需要通过几种可能的手术方法之一进行手术重建。