本篇研究我們採用回溯法之病歷整理與分析，收集從1984年至1997年底台大泌尿部所治療處理婦產科術後泌尿道併發症的病例。每一名病例皆詳細記錄其原發病變，婦產科手術之方法及重要參數，泌尿道併發症之種類，位置及術後診斷的時間，以及泌尿科處理的方法。此外本篇另收集了70例婦產科診斷、手術、及年齡層相似而無泌尿道併發症之病例做為對照組，以進一步研究造成婦產科術後泌尿道併發症可能之因子。去除非單純性手術併發因子，如合併放射性治療或腫瘤復發等83名，共收集了109個病例：49名病人接受根除性子宮切除術，42名單純子宮切除術，6位腹腔鏡子宮手術，2 位輸卵管切除術，2 位尿道旁膿瘍引流，及產後併發症8名。我們將收集病例的泌尿道併發症共歸類為八項：32名膀胱陰道廔管，27名輸尿管陰道廔管，26名單側輸尿管狹窄，11名兩側阻塞性輸尿管腎病變，11名排尿障礙，9名術中發現輸尿管傷害，3名術中發現膀胱傷害和1名尿道陰道廔管。本篇對於各種泌尿道併發症形成的時間、症候、及處理，包含保守治療及各種手術處理，皆詳細的描述與整理分析，其中特別提出4名膀胱陰道廔管和2名輸尿管陰道廔管的病患僅接受單純的尿道導管置放和雙J管置放後痊癒。經過對照組的比較統計，發現接受婦產科根除手術後泌尿道併發症之患者，有明顯較多量的術中出血；接受婦產科單純子宮切除術後泌尿道併發症之患者，除手術中的出血量較多外，手術時問也明顯的增長。另外本篇提出兩點以往此類文獻中較少提出的重要觀察：一為在長期追蹤下，輸尿管阻塞的病變比例事實上相當高；另一為根除性子宮切除術在本研究中是造成泌尿道併發症的重要術式，其所佔的比例甚至比單純子宮切除術要來的高。

This retrospective study examined urologic complications of obstetrico-gynecologic surgery managed at our department from January 1984 to December 1997. Each patient was reviewed for her original diagnosis, operative parameters, types and locations of injury, time of recognition, and methods of repair. Patients of matched diagnosis, age, and surgery with no complication were randomly chosen as the control groups to evaluate possible predisposing fac-tors. Among the 109 cases included, 8 were obstetric patients, 49 received radical hysterectomy and pelvic lymph node dissection (PLND), 42 had a simple hysterectomy, 6 received operative laparoscopic procedures, 2 had salpingectomy, and 2 received excision of a periurethral abscess. There were 120 events of urologic complications in these 109 cases, including vesicovaginal fis-tulae (32cases), intraoperatively recongnized injury to the urinary bladder (3cases), uretero-vaginal fistulae (27cases), intraoperatively recognized injury to the ureter (9cases), unilateral ureteral stricture (26cases), bilateral ureteral obstruction (11cases), voiding dysfunction (11cases), and urethrovaginal fistulae (lease). The time and symptoms of presentations and the management of each type of complication are described in detail. When compared with the control cases, the patients receiving radical hysterectomy and PLND with complications had more intraoperative blood loss (p<0.01); and patients receiving simple abdominal hysterectomy with complications had longer operation time and more blood loss (both p<0.01). Our series is unique in that a high incidence of ureteral obstruction was disclosed, and because radical hysterectomy played an very important role in causing urological complications. These 2 issues were not em-phasized in previous relevant literature.