经腹腔镜全子宫切除术时应用的特种钉可损伤输尿管。下面报道的2例尿瘘其发生与使用腹腔镜钉无关: 例1 30岁,因卵巢交界性浆液囊腺癌经腹腔镜全子宫及左附件切除。2个月前在另一医院切除阑尾和右卵巢肿瘤。腹腔镜下见盆腔广泛粘连看不到盆腔器官。松解粘连后分离了双侧输尿管,完整的标本距阴道断端仅1cm,切除后关闭阴道断端。术后静脉肾盂造影显示一膀胱小漏孔及未充满造影剂的尿性囊肿。放置Foley尿管于术后第14天经阴道仍漏尿遂诊断为输尿管瘘。输尿管逆行插管失败。经皮肤肾造口后停止漏尿,带引流管3个月。最后做输尿管重新植入膀胱术治愈。术时发现结扎了输尿管膀胱连接处。 例2 39岁,因长期持续盆腔痛经腹腔镜全子宫 Laparoscopic hysterectomy with special nails can damage the ureter. The following two cases of urinary fistula were reported to have nothing to do with the use of laparoscopic nail: Example 1 30 years old, due to ovarian borderline serous cystadenocarcinoma by laparoscopic uterine and left accessory resection. The appendix and right ovarian tumor were resected in another hospital two months ago. See laparoscopic pelvic adhesions do not see pelvic organs. Release adhesions bilateral ureter was isolated, the complete specimen away from the vagina only 1cm, after the closure of the vagina off. Postoperative intravenous pyelography showed a small cyst leak and urinary cyst not filled with contrast agent. Foley catheter placed on the 14th day after the vaginal leakage of urine was diagnosed as ureteral fistula. Ureteral retrograde intubation failed. Transdermal nephrostomy to stop leakage of urine, with drainage tube for 3 months. Last ureter re-implanted bladder cure. Surgery was found ligation of the ureter bladder junction. Case 2 39 years old, laparoscopic whole uterus due to long-term continued pelvic dysmenorrhea