尿管カテーテル法に際してみられた尿管損傷,尿管異物などの偶発症

Abstract

During the period of 8 years since 1955, 12, 043 ureteral c atheterizations were performed for the purpose of retrograde pyelography in the department of urology at Kyoto University Hospital. Among them, unexpected accidents, 8 cases of ureteral rupture with extravasation of contrast media, 1 case of foreign body due to breakage of catheter and 5 cases of intraureteral looping of catheter, occurred. The lesions of the uretera l rupture were in 'the lower portion of the ureter in all of 8 cases. The damaged portions were under the situations of presence of ureteral stone, hydroureter, wound after ureterolithotomy, ureteritis following passage of stone and ureteral tuberculosis in each one case and possibly normal ureter in 3 cases. Although the patients developed pain at pouring contrast media in 7 out of 8 cases, no serious residual damage was recognized in all cases. In the case of re m aining of breakage of cathater, the piece was operatively removed along with ureterolithotomy of the opposite side. All of cases resulted in intraureteral c atheter looping were possessed with either one of congenital, urolithiasic, tuberculous or neoplastic hydroureter. In one of them the loop turned in tangle formation. Discussions w e re made on the cause of accidents, and its prevention was stated.