最近3年間における婦人科手術後の泌尿器科手術23症例の検討

Abstract

婦人科手術後に泌尿器系疾患を併発し手術を施行した23例について検討した.1)婦人科手術中に泌尿器系臓器を直接損傷したものは6例(26%)である.婦人科悪性腫瘍が3例, 良性腫瘍が3例であった.損傷臓器は尿管が4例, 膀胱が2例であった.2)婦人科手術後に泌尿器系疾患を併発したものを間接障害例とし, 17例(74%)に存在した.全例とも婦人科悪性腫瘍患者であった.当科受診時の症状は, 尿毒症症状6例, 腹痛2例, 膀胱の大出血5例など緊急手術を要する状態の患者が多かった

The urological treatment and analysis of 23 patients with urological disorders after gynecological operation during the past three years were studied. Primary trauma of ureter, bladder and other urological organs that was caused by gynecological operation occurred in 6 cases (26%) consisting of 3 malignant tumor cases, and 3 benign tumor cases. Injured organs were 4 cases of ureter and 2 cases of bladder. Reconstruction of ureter and ureterovesical implantation were performed to all those patients except one who suffered from schizophrenia, and these operations brought favorable results. Secondary trauma that caused urological disorder after gynecological operation was found in 17 cases (74%), all of which were induced by radical operation against malignant tumors. The symptoms were uremia, abdominal pain, vesicovaginal fistula, severe bladder bleeding with poor general condition. In most cases, uretero-cutaneostomy was performed as emergency measures, and recontruction of ureter was possible in 3 cases. It is presumed that urological operation for secondary damage is favorable, since only one patient died of uremia.