제왕절개술 후 발생한 요관-자궁 샛길 1예
A case of ureterouterine fistula as a complication of cesarean section
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요관 손상의 복강경이나 부인과적 수술 중 많이 발생하며 대개 의인성이다. 요관-자궁 샛길은 의인성 비뇨생식기 샛길 중 매우 드문 질환으로, 제왕절개술의 과거력을 가진 환자에서 가장 흔히 발생한다. 치료 방법으로는 보존적 치료 또는 스텐트를 이용하거나 요관-방광이음술 또는 요관사이이음술 등의 수술적 치료가 있다. 저자들은 선행 제왕절개술 후 자연분만을 시도하다가 제왕절개수술을 시행한 후 수양성 질분비물을 주소로 내원하여 요관-자궁 샛길로 진단되어 요관-방광이음술을 시행하였던 1예를 경험하였기에 간단한 문헌고찰과 함께 보고하는 바이다.
Abstract
Ureteral injury is usually iatrogenic in origin, in particular as a result of laparoscopic or gynecological surgery. Ureterouterine fistula constitute a rare subset of iatrogenic genitourinary fistulas. The most common presentation of ureterouterine fistula is in women who have had a cesarean section. The management options include conservative therapy (spontaneous healing), endourologic (stented repair) or open surgical operation (ureteroneocystostomy or ureteroureterostomy). Herein, we report on a case of ureterouterine fistula in a 33-year-old woman who underwent a cesarean section. The 17th day after the operation, she complained watery vaginal discharge. Clinical and urographic assessments revealed an iatrogenic ureterouterine fistula and an ureteroneocystostomy was performed after 3 months.
참고문헌 (12)
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