泌尿系梗阻与子宫内膜异位症(附二例报告)

Obstruction of urinary tract due to endometriosis(report of 2 cases)

目的 探讨子宫内膜异位症 (EMS)引起泌尿系梗阻的诊断与治疗方法。 方法 1997～ 2 0 0 0年收治EMS患者 2 3例 ,其中 2例侵犯泌尿系 ,造成肾脏及输尿管积水、扩张 ,术中行子宫次全切除、盆腔包块切除及输尿管周围组织粘连松解。 结果 2例术后 7～ 10d复查梗阻均解除 ,随访 2年 ,未见复发。 结论 对EMS引起泌尿系梗阻应予以重视 ,EMS患者术前应常规行泌尿系B超 ,必要时行IVU检查 ;术中注意输尿管及其周围组织粘连病灶的探查及处理 ;术后常规服用 6个月孕三烯酮类药物 ,定期随访 。

Objective To study the diagnosis and treatment of ureteral obstruction caused by endometriosis. Methods Out of 23 patients suffered from endometriosis treated from 1997 to 2000,ureteral obstruction occurred in 2 accompanied by hydronephrosis and dilatation of ureter.Both the 2 underwent sub total hysterectomy, resection of the intumescence in pelvic cavity, and the ureter was freed from the surrounding tissue. Results Ureteral obstruction was relieved in 7～10 days after the procedure. Both the petients were followed up for 2 years without recurrence. Conclusions Attention shoud be called to ureteral obstruction caused by endometriosis.Ultrasonic examination and intravenous pyelogram before operation, close examination of the ureter and adequate freeing of the ureter from it's surrounding tissue during operation, the application of gestrinone for 6 months after the operation, and scheduled following up would yield a satisfactory outcome.