Balon kengayishi qanday ishlaydi?
Through the urethra and bladder at the mouth of the ureter, under X-ray control, a guide is passed through the stricture, along which a balloon catheter is installed, which is installed exactly in the area of narrowing and inflated with diluted contrast for 3–5 minutes; Tasvir balonning "belining" yo'qolishini kuzatadi. Ba'zida dilatatsiya chandiqning lazerli diseksiyasi bilan to'ldiriladi (endoureterotomiya). Keyinchalik katta diametrli stent 4-6 hafta davomida joylashtiriladi. Balon strikturani teng ravishda cho'zadi, bu bougienagega qaraganda kamroq shikastlidir va bo'shashmasdan toraygan holda yaxshi natijalar beradi.
Uterer strikturasining sabablari va belgilari
Narrowing of the ureter develops after trauma during stone removal, radiation therapy, surgery on the pelvic organs, tuberculosis, long-term stone retention; ureteropelvik segmentda konjenital strikturalar paydo bo'ladi. Hidronefroz, pastki orqa qismida zerikarli og'riqlar, infektsiyalar, buyraklar faoliyatining pasayishi bilan namoyon bo'ladi. Tashxis MSCT urografiyasi va retrograd ureteropyelografiya orqali amalga oshiriladi, buyrak funktsiyasi sintigrafiya bilan baholanadi.
Endoskopik davolash yoki plastik jarrohlik
Bougienage and balloon dilatation are minimally invasive methods for short (up to 1–1.5 cm) loose strictures without severe ischemia: effectiveness is 50–70%, recovery is fast, but relapses are frequent. For extended, dense, radial and recurrent strictures, reconstructive surgery is indicated - ureteroureteroanastomosis, ureterocystoneoanastomosis or pyeloplasty with an effectiveness of 85–95%. Agar buyraklar faoliyati buzilgan bo'lsa, birinchi navbatda endoskopik usulni sinab ko'rish mumkin.
