Frego E, Scanzi M, Aulenti V, Zambolin T, Giambroni L, Cancarini G
Divisione Clinicizzata di Urologia, Spedali Civili di Brescia.
Arch Ital Urol Nefrol Androl. 1993 Mar;65(1):41-6.
The injuries to the ureter, whether from external trauma or iatrogenic, are rare. Some problems are common to this type of pathology, independently from the causes of injuries. It is necessary a prompt diagnosis of the lesion to avoid the urinar leakage, the infection and the fibrosis of the ureteral's stumps. If the diagnosis is not prompt, the clinical pattern may be silent for some days; after, many complications will arise up: sepsis, urinomas and fistulas. When the lesion is incomplete, and there is no devascularization, the urine drainage alone, positioned above the level of the lesion, is indicated for spontaneous repairing. When the ureteral tissue loss is extensive, it is not enough a simple anastomosis between the ureteral's stumps; in these cases is necessary a more complex repair surgery or ureteral substitution.
输尿管损伤，无论是由外部创伤还是医源性因素引起，都较为罕见。这类病理情况存在一些共同问题，与损伤原因无关。必须对病变进行及时诊断，以避免尿液渗漏、感染以及输尿管残端纤维化。如果诊断不及时，临床症状可能会在数天内不明显；之后，会出现许多并发症：败血症、尿瘤和瘘管。当病变不完全且没有血管化时，仅在病变水平上方放置尿液引流管，以促进自发修复。当输尿管组织损失广泛时，输尿管残端之间简单的吻合是不够的；在这些情况下，需要更复杂的修复手术或输尿管替代术。
