The Dianosis And Treatment Of Ureteral Obstraction With Endoscopy

Background: Ureteral obstructive disease is common clinically. There are many causes of ureteral obstructive disease and the diseased region are different, the obstruction will result in renal functional incapacitation, if the ureter is obstructed bilaterally, it will result in renal failure. In the past, the causes of ureteral obstruction were mostly diagnosed by imaging such as B ultrasonography IVU CT MRI, and the trearment was open operation. For the past few years, the application and popularization of endoscopic technique promote the surgical technique to be slightly traumatic and intracavitary, elevate the diagnostic level of ureteral obstructive disease, .avoid the trauma of open operation, and make the diagnosis and treament can be applied repeatedly. In order to investigate the diagnositic and therapeutic value of endoscopic technique for ureteral obstructive disease, we studied 212 cases of ureteral obstructive disease.The ureteral obstructive diseases referred in this article include ureteral calculi ureterocele polypi stenosis and tumor. The endoscopes include Germany Wolf ureterorenoscopyN ureteral resectoscopy bladder resectoscopy percutaneous nephroscopy and Swiss EMS III ultrasound pneumatic lithotripter.Objective: 1. To investigate the diagnostic value of endoscopy for the ureteral obstructive disease which can not be confirmed by imaging. 2. To evaluate the clinical efficacy of endoscopy combined with electric resection pneumatic lithotripsy for the treatment of the ureteral obstructive disease. 3. To expound thatthe endoscopy can be used for the diagnosis and treatment for the ureteral obstructive disease, and can provide possible advantage for successive treatment.Methods: 212 cases of ureteral calculi stenosis polypi ureterocele and tumor from January 2002 to January 2004 were confirmed by endoscopy, some cases received endoscopyic biopsy and were confirmed by pathology; All cases were treated by Germany Wolf bladder resectoscopy ureterorenoscopy . ureteral resectoscopy, percutaneous nephroscopy or combination of two or three methods according to different disease combined with Swiss EMS III ultrasound pneumatic lithotripter monitored by television.Results: There were 166 cases with ureteral calculi, 5 cases with ureterocele, 21 cases with ureteral stenosis, 11 cases with ureteral polypi, 9 cases with ureteral tumor. 212 cases received the treatment of endoscopy (14 cases were confirmed by endoscopy and received treatment at the same time.) . The successful rate was 94.3%, and2.3% occurred complications such as ureterperforation ureteral mucosa avulsion, etc.Conclusions: 1. Endoscopy is helpful in detecting smaller silent calculi, identifying the pathologic features of ureteral space occupying lesion, and confirming the diagnosis of ureteral tumor. 2. Endoscopy is helpful in diagnosis and treatment at the same time for most of the ureteral obstructive disease. 3.Endoscopy combined with electric resection pneumatic lithotripsy provide effective treatment for the ureteral obstructive disease. 4. Endoscopy can be used repeatedly because it is slightly traumatic and highly effective, and make it possible to apply successive treatment. 5. Endoscopy can shorten diagnosis and treatment period and decrease therapeutic cost.