Clinical Diagnosis And Treatment Of Ureteral Injury In 28 Cases

Background: Ureter is a retroperitoneal organ,which is elongated and soft.Injuries caused by direct trauma are rare.Iatrogenic injuries are the main clinical causes,which are mostly manifested as abdominal distension,pain,discomfort and fever.Radiation therapy for pelvic tumors causes radiation pelvic disease(PRD),which increases the number of radioactive ureteral injuries.Iatrogenic ureteral injury is common,which undoubtedly aggravates the economic and mental burden of patients and has a negative impact on the doctor-patient relationship.Domestic and foreign experts and scholars have different diagnosis and treatment strategies for ureteral injury,which have not been completely unified.Therefore,the diagnosis and treatment of ureteral injury is analyzed,and experience summary and efficacy evaluation are conducted.Methods: The clinical data of 28 patients with ureteral injury admitted to our hospital from January 2011 to February 2017 were retrospectively analyzed,and the basic information of the patients,relevant laboratory examinations,imaging examinations and surgical records were collected and sorted.The operation was performed by double-j tube drainage(d-j),uretero-bladder replantation(UR),ureteroureterostomy(UU),uretero-bladder replantation with large lumbar suspension,permanent nephrostomy and ureteroderomy for urinary diversion.Postoperative outpatient/ward follow-up,regular monitoring of renal function,observation of ureteropelvic morphology.Results: In 28 cases of ureteral injury in patients with Chinese medicine source sex injury in 24 cases,4 cases of trauma including 17 patients with routine of double J tube drainage condition get effective treatment and relief,3 cases of first percutaneous nephroscope colostomy surgery before the kidney ureteral resection in replantation of bladder,ureteral injury end to end anastomosis,ureter,bladder suspension repair successful replantation waist,2 ureteral end to end anastomosis,1 bladder ureter replantation repair success,5 routine permanent kidney ureteral fistula and skin urinary diersion colostomy.Conclusion:Ureteral injury should be diagnosed early and treated in time,and the effect of early surgical reconstruction is ideal,which is extremely important for urine drainage to protect renal function,and iatrogenic ureteral injury should be prevented in the first place.Compared with conservative treatment with double J tube implantation,ureteral reconstructive surgery has a shorter treatment cycle despite different injury mechanisms and degrees,although active reconstruction should be considered if conditions permit.Ureteral injury caused by radiotherapy can cause long segment ureteral stenosis and stiffness,the treatment cycle is prolonged,the effect is not good,and should be actively prevented before radiotherapy.