腹腔鏡式輸尿管膀胱吻合術修補子宮內膜異位症導致之下段輸尿管狹窄
蔡秉儒，歐朝士
高雄市阮綜合醫院 外科部 泌尿科
Laparoscopic modified ureteroneocystostomy to manage distal ureteral stricture following endometriosis treatment
1Ping-Ju Tsai, 2Chau-Su Ou
1Division of Urology, Department of Surgery, and 2department of Gynecology, Yuan’s General Hospital, Kaohsiung, Taiwan
Abstract
Among the complications of endometriosis management, electrocautery injury of ureter was the nightmare of the gynecologists. Ureteral injury wound result in urine leakage, ureteral stricture, hydronephrosis, and even subsequent loss of kidney function.
One 40 year-old female patient had bilateral distal ureteral stricture following endometriosis electrocauterization surgery 4 years ago. We performed laparoscopic ureterolysis and double-J catheters in bilateral ureters. Her right side ureteral stricture and hydronephrosis became improved. Unfortunately, her left side hydronephrosis persisted. Therefore, we performed left laparoscopic modified extravesical Lich-Gregoir ureteroneocystostomy for her. Two days later, she discharged from the hospital. After one month, we removed her double-J tube at outpatient department. Laparoscopic modified extravesical Lich-Gregoir ureteroneocystostomy is a simple and effective method. We greatly hope to decrease the patient’s suffering and medical dispute.