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输尿管阴道的
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     ECTOPIC URETERAL ORIFICE
     输尿管开口异位
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     Ectopic Ureteral Oriffice (6 Case Report)
     输尿管异位开口
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     Transvaginal intratubal insemination
     经阴道的输卵管内人工授精
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     RECONSTRUCTION FOR CONGENITAL ABSENCE OF VAGINA
     先天性无阴道的外科治疗
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  ureterovaginal
Ureterovaginal fistula following laparoscopic-assisted vaginal hysterectomy-a case report with review of literature
      
The authors present a case of ureterovaginal fistula following laparoscopy-assisted vaginal hysterectomy, which was successfully managed by ureteroneocystostomy with bladder psoas hitch.
      
Use of endoscopy in the management of postoperative ureterovaginal fistula
      
The aim of the study was to evaluate endourological techniques in the management of iatrogenic ureterovaginal fistula.
      
Seventeen patients referred to us after gynecologic surgery were diagnosed as having iatrogenic ureterovaginal fistula.
      
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From 1973 to 1985,441 patients with cervical carcinoma underwent radical hysterectomy treatment in our department. Among them the incision extent of 84 patients was measured during oper ation,42 cases being stage Ⅰ_ b,36 cases stage Ⅱ_a,and 6 cases stage Ⅱ_b. The excision extent of cardinal ligaments was 8~14cm~2, utero-sacral ligaments 12~19cm~2, paravaginal 2.5~5.9cm~2 and the vaginal 2~3.5cm. The five-year and ten-year survival rates of these patients were higher than those of the patients with large incision...

From 1973 to 1985,441 patients with cervical carcinoma underwent radical hysterectomy treatment in our department. Among them the incision extent of 84 patients was measured during oper ation,42 cases being stage Ⅰ_ b,36 cases stage Ⅱ_a,and 6 cases stage Ⅱ_b. The excision extent of cardinal ligaments was 8~14cm~2, utero-sacral ligaments 12~19cm~2, paravaginal 2.5~5.9cm~2 and the vaginal 2~3.5cm. The five-year and ten-year survival rates of these patients were higher than those of the patients with large incision extent,that is to say,enlarging the operation extent not only increased the survival rate, but also decreased it slightly. However,it was no statistical significance(P>0.05) as compared with the small incision extent. After operation, 100% of the patients were followed up. The five-year survival rate was 94.05%. Among them stage Ⅰ_b, Ⅱ_a, Ⅱ_b, being respectively 95.24%,94.44% and 5/6. The incidence of urine ratention after operation was 11.91%(10/54), ureteral fistula 2.38%. In this paper,the proper operation extent,the reduced postoperation complication, the surgical factors increasing the curative effect on the patients with lymph nodes metastasis,and the problem of the operation on the patients of stage Ⅱ_b are discussed.

我院1973~1985年作宫颈癌根治术441例,其中84例术时进行切除范围的测量。Ⅰ_b期42例,Ⅱ_a期36例,Ⅱ_b期6例。切除主韧带8~14cm~2,宫骶韧带12~19cm~2,阴道旁2.5~5.9cm~2,阴道2~3.5cm。5年、10年存活率较多切除者高,即切除范围扩大存活率未见增加而略有降低。但经统计学检验差异无显著性(P均>0.05)。提示上述切除范围对Ⅰ_b期、Ⅱ_a期是合适的。本组随访率100.0%。5年存活率94.05%,其中Ⅰ_b期95.24%,Ⅱ_a期94.44%,Ⅱ_b期5/6。术后尿潴留占11.91%(10/84),输尿管阴道瘘占2.38%(2/84)。本文对手术合适的切除范围、降低术后并发症、提高对淋巴结转移的疗效及Ⅱ~b期手术问题进行了讨论。

In order to pay great attention to d1agnosis, treatment and prevention of iatrogenic urinary fistura, 24 patients with iatrogenic fistura were l)resented form l964 t0 1997. 0perati0n of Gynecol0gyand obstetrics contrlbuted to urinary fistula in 16 cases, (56. 5 % ), operation of general surgery in 4 cases(17. 3% ), operation of urology in 6 cases (26 % ). This sereis included uretero-vaginal festula, vasical-vaginal fistula, vasico- uterine fistula, uretero-cernvix- vaginal fistula, ureteroileal fistula, uretero-cutaneous...

In order to pay great attention to d1agnosis, treatment and prevention of iatrogenic urinary fistura, 24 patients with iatrogenic fistura were l)resented form l964 t0 1997. 0perati0n of Gynecol0gyand obstetrics contrlbuted to urinary fistula in 16 cases, (56. 5 % ), operation of general surgery in 4 cases(17. 3% ), operation of urology in 6 cases (26 % ). This sereis included uretero-vaginal festula, vasical-vaginal fistula, vasico- uterine fistula, uretero-cernvix- vaginal fistula, ureteroileal fistula, uretero-cutaneous flstula, rectourethral fistula, uretero- paritoneal cavity flstula, veslco-cutaneous fistula. Theiatrogenic etiology, clinlc symtoms, diagnosis and treatment of iatr0genic urinary flstula has been discussed.

为了重视医源性尿瘘的诊治和预防,我们报告了1964~1996年我院收治的24例外科医源性尿瘘.其中与妇产科有关的14例占56.5%,与普外科有关的4例占173%,与泌尿外科有关的6例占26%.包括输尿管阴道瘘、膀胱阴道瘘、膀胱子宫瘘、输尿管宫颈瘘、输尿管回肠瘘、输尿着皮肤瘘、尿道直肠瘘、输尿管腹腔瘘、膀胱腹壁瘘等各种情况。本文对医源性尿瘘的病因、临床症状和治疗进行了讨论.

From 1965 to 1994, 10 cases of ureterovaginal fistula were treated. The fistula occurred as a complication of gynecological operation in all, occurring 3 to 30 days postoperatively with a mean of 13.4 days. The diagnosis was established readily on IVU, cystoscopy, retrograde pyeloureterography or dye studies. All the patients underwent ureterocystostomy and have been followed up for 1~2 years with satisfactory result. Early repair of ureterovaginal fistula was recommended.

自1965~1994年共收治输尿管阴道瘘患者10例。均发生于妇科手术后。尿瘘发生时间为术后3~30天,平均13.4天。联合应用IVU、膀胱镜、逆行输尿管肾盂造影及染料染色检查确诊。患者均行输尿管膀胱再吻合术,随访1~2年,全部治愈。认为早期修复输尿管阴道瘘是适宜的

 
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