抄録
Post-surgical ureter stricture is caused in most by ligation of the periureter tissue and curvation of ureter at the surgical procedure of anterior and posterior vesico-uterine ligament. However, we experienced the cases in which ureter was stricted by unusual adhesion on the crossing part of common iliac artery. In this presentation, clinical courses of the patients, personal opinion on prevention and treatment of this kind of complication were reported.
Case 1. Operation and post-operative course were favourable. The sign of ureter stricture of both sides was seen 60 days after surgery and died of uremia on the 167th post-operative day. Autopsy revealed that both sides of ureter adhered at the crossing part of common iliac artery to obstruct.
Case 2. Ureter stricture of the right side was suspected on the 32th post-operative day, and the stricture was diagnosed by relaparotomy on the 40th day. As isolation of ureter from adhesion was impossible, the stricture was made loose by catheterization.
In order to prevent this kind of disturbance of the ureter it is recommended not to isolate ureter from common iliac artery. When it is needed to do so, ureter should be cathetered to make least the contact area of ureter and artery. The intraperitoneal position of ureter in which the peritoneum is placed between ureter and artery will be an effective method.
Ureter catheterization should be performed to treat the strictured ureter. If impossible of this, prompt surgical procedure to eliminate the stricture will be needed. Even if the stricture develops on one side, these methods of treatment are necessary to keep the function of kidney on the involved side normal.
