盆腔器官脱垂阴式手术时输尿管梗阻的发生率及术中膀胱镜的应用价值

作     者：Gustilo-Ashby A.M. Jelovsek J.E. Barber M.D. 吕涛 

作者机构：Division of Urogynecology and Reconstructive Pelvic Surgery Department of Obstetrics and Gynecology The Clevel and Clinic Foundation Cleveland OH United States Dr 

出 版 物：《世界核心医学期刊文摘（妇产科学分册）》 (Core Journal in Obstetrics/Gynecology)

年 卷 期：2006年第2卷第9期

页      面：31-31页

学科分类：1002[医学-临床医学] 100211[医学-妇产科学] 10[医学] 

主　　题：盆腔器官脱垂 输尿管梗阻 膀胱镜检查 手术中 发生率 手术时 阴式 价值 

摘      要：Objective: The objective of the study was to determine the incidence of ureteral obstruction during vaginal surgery for pelvic organ prolapse and the accuracy and efficacy of intraoperative cystoscopy. Study design: The study was a retrospective review of 700 consecutive patients who underwent vaginal surgery for anterior and/or apical pelvic organ prolapse with universal intraoperative cystoscopy. Results: Thirty-seven patients (5.3% ) had no spillage of dye from 1 or both ureters intraoperatively. The false-positive and negative cystoscopy rates were 0.4% and 0.3% , respectively. Thus, the true incidence of intraoperative ureteral obstruction was 5.1% . Intraoperative cystoscopy was accurate in 99.3% of cases, with a sensitivity and specificity of 94.4% and 99.5% , respectively. Suture removal relieved ureteral obstruction in 88% of cases. Six subjects (0.9% ) had true ureteral injuries. Conclusion: Vaginal surgery for anterior and/or apical pelvic organ prolapse is associated with an intraoperative ureteral obstruction rate of 5.1% . Intraoperative cystoscopy accurately detects ureteral obstruction and allows for relief of obstruction in the majority of cases.