Kriegmair M, Schmeller N
Department of Urology, University of Munich, Germany.
Urology. 1995 Apr;45(4):578-80. doi: 10.1016/S0090-4295(99)80046-6.
Ureteroscopy has become an effective and safe procedure for treatment of ureteral calculi. Formation of strictures are considered long-term complications with a low incidence. This report focuses on the incidence of strictures in cases of calculi pushed or flushed retroperitoneally alongside the ureter because of iatrogenic ureteral perforation.
Fifteen consecutive patients with paraureteral calculi caused by ureteroscopic perforation were observed. An excretory urogram was performed after a mean of 22.5 months, with a range of 9 to 54 months. In all patients, a stent was placed for 3 to 41 days (mean, 13.5 days) and antibiotics were administered between 3 and 5 days postoperatively.
Only 1 patient of 15 with a short stricture of the distal ureter was observed. The stricture was successfully treated by endoscopic ureterotomy, balloon dilation, and transient placement of a ureteral stent.
Paraureteral calculi caused by ureteral perforation are a minor complication of ureteroscopy, which rarely lead to formation of strictures. Removal of paraureteral calculi by enhanced endoscopic procedures or open surgery is not required.
输尿管镜检查已成为治疗输尿管结石的一种有效且安全的方法。狭窄形成被认为是一种发生率较低的长期并发症。本报告聚焦于因医源性输尿管穿孔导致结石沿输尿管在腹膜后被推移或冲洗的病例中狭窄的发生率。
观察了15例因输尿管镜穿孔导致输尿管旁结石的连续患者。平均22.5个月（范围9至54个月）后进行排泄性尿路造影。所有患者均放置支架3至41天（平均13.5天），术后3至5天给予抗生素。
15例患者中仅观察到1例输尿管远端短段狭窄。该狭窄通过内镜下输尿管切开术、球囊扩张及临时放置输尿管支架成功治疗。
输尿管穿孔导致的输尿管旁结石是输尿管镜检查的一种轻微并发症，很少导致狭窄形成。无需通过强化内镜手术或开放手术取出输尿管旁结石。
