经阴道超声取卵术后泌尿系损伤的20例临床分析

目的探讨辅助生殖技术中女方经阴道超声取卵手术导致泌尿系损伤的临床特点及诊断、处理措施。方法回顾性分析广西壮族自治区生殖医院2012年至2020年辅助生殖技术女方取卵手术中发生泌尿系损伤的临床资料、疾病类型、发现时机、诊治情况、预后及处理措施。结果 44 144例取卵手术中,发生泌尿系损伤20例,发生率为0.045%。其中膀胱损伤19例,输尿管损伤1例。在膀胱损伤中,术中发现1例,术后发现18例,输尿管损伤为术后发现。其中有8例是在进行了胚胎移植术后才发现,最终有4例获得妊娠。全部的病例经对症处理、膀胱冲洗和(或)膀胱镜检查、止血等治疗后,均痊愈。结论在辅助生殖技术中女方取卵手术损伤虽小,但要注意防范泌尿系损伤发生的风险,及时发现并处理,利于辅助生殖技术的后续治疗。

Clinical analysis of 20 cases of urinary system injury after transvaginal ultrasound ovum retrieval

Objective To investigate the clinical characteristics, diagnosis and treatment of urinary system injury caused by transvaginal ultrasound ovum retrieval in assisted reproductive technology.Methods The clinical data, disease types, detection time, diagnosis and treatment, prognosis and treatment measures of urinary system injury in Reproductive Hospital of Guangxi Zhuang Autonomous Region from 2012 to 2020 were retrospectively analyzed.Results among the 44 144 cases, 20 cases had urinary system injury, the incidence rate was 0.045%.There were 19 cases of bladder injury and 1 case of ureter injury.In bladder injury, 1 case was found during operation, 18 cases were found after operation, and ureteral injury was found after operation.Among them, 8 cases were found after embryo transfer, and finally 4 cases got pregnancy.All cases were cured after symptomatic treatment, bladder irrigation and/or cystoscopy, hemostasis and so on.Conclusion In assisted reproductive technology, although the damage of ovum retrieval operation is small, we should be alert to the risk of bladder and ureter injury, and timely find and deal with it, which is conducive to the follow-up treatment of assisted reproductive technology.