Ureteral amputation in the implementation of contact ureterolithotripsy: diagnosis and treatment tactics (clinical observation)

Amputation of the ureter is a complication in which its separation occurs on two levels. The frequency of this complication in the world literature varies from 0.1 to 0.2%. From 2008 to 2015 in the urological clinic MONIKI n. M.F. Vladimirsky 545 years endoscopic operations were performed in 506 patients with ureterolithiasis. In our study, ureteral amputation was noted in one observation (0.2%). One of the possible mechanisms of amputation of the ureter may be the invagination of its wall in the zone of the calculus. At the time of invagination, the distal ureter is first detached in the mouth zone, and when the instrument is removed, a detachment occurs in the intussusception zone. In foreign literature, when describing the mechanism of ureteral amputation, the term "scabbard avulsions" is used, which can be translated literally as a "sheath" detachment. In our opinion, we will more often use the term "invagination effect" in this situation. To date, the choice of surgical and plastic correction of this complication, is associated with a number of difficulties. The volume of surgical intervention is determined depending on the level of localization of its defect and extent, the state of parainal tissue.