経尿道的尿管砕石術(Transurethral lithotripsy;TUL)における術前Double-J catheter留置の有用性

Abstract

1) 55例のTULを術前にD-J catheterを留置した27例, D-J catheterを留置しなかった28例に分類した.2) D-J catheter留置により尿管の拡張がえられ, 尿管ブジーを要さずに容易に尿管鏡の挿入が行える.3)尿管鏡操作が容易なために手術時間の短縮ができる.4)尿管の拡張は3日間のD-J catheterの留置で充分であった.5)膀胱刺激症状を与えた症例もあるが, 症状に耐えられず抜去することはなかった.6) D-J catheter留置の有無にかかわらず術後の経過に差異はなく, 経過観察期間にはTULによる尿管狭窄は認められなかった

Transurethral lithotripsy (TUL) was performed in the cases in which the ureteral calculi were not destroyed by the extracorporeal shock-wave lithotriptor (Dornier HM-3, EDAP LT 01). Preoperative placement of double-J ureteral catheter (D-J catheter) caused ureteral dilation, allowing smooth insertion of the ureteroscope. We divided the 55 TUL cases into two groups, those with (27) or without (28) a D-J catheter placed preoperatively, and compared requirement of ureteral bougination, difficulty of ureteroscope insertion and duration of operation between the two groups. In all cases with a D-J catheter, ureteral bougination was not necessary, the insertion of ureteroscope was easier and the duration of operation was shorter than the cases without a D-J catheter. Bladder irritable symptoms were seen in some cases with a D-J catheter but did not require removal of the D-J catheter. On the follow-up term after TUL, there was no difference in the incidence of postoperative fever or postoperative ureteral stenosis, between the cases with and those without a D-J catheter.