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1.
重复尿道并泌尿生殖系多发畸形1例报告及文献复习 总被引:1,自引:0,他引:1
目的 探讨女性重复尿道并泌尿生殖系多发畸形的临床特征及诊治方法.方法 总结1例女性重复尿道并泌尿生殖系多发畸形的临床资料.检索Pubmed和CNKI数据库相关文献进行复习.结果 病例系临床罕见多系统、器官合并畸形,因生殖器官发育差,诊断欠明确,定期随访.榆索结果表明相似文献报道少见,并多合并其他泌尿生殖系畸形.结论 女性尿道重复在泌尿系畸形中比较罕见.诊断时详尽的体格检查至关重要,在此基础上行针对性辅助检查,检查应以无创检查为主.根据解剖情况及临床表现行相应的治疗. 相似文献
2.
本文采用邻苯三酚比色法测定20例膀胱癌、7例泌尿生殖系非膀胱肿瘤、20例泌尿生殖系非肿瘤患者和20例健康人血红细胞CaZn-SOD的活性。结果膀胱癌组红细胞CuZn-SOD活性明显低于健康人组和泌尿生殖系非肿增疾病组,其差异有显著性意义(P<0.01)。泌尿生殖系非膀胱肿瘤组中,肾癌患者红细胞CuZn-SOD活性值与健康人有重叠;前列腺癌患者与膀胱癌组中的高值接近;阴茎癌与睾丸癌则与膀胱癌组中的低值相近。若以CuZn-SOD活性值低于929.09u/gHb为诊断标准,则膀胱癌组低于此值的为70%(14例),而健康人组和泌尿生殖系非肿瘤疾患组中无一例低于此标准值。认为可将红细胞CuZn-SOD活性测定作为膀胱癌的一个辅助诊断指标。本文还探讨了CuZn-SOD活性变化的有关临床用途。 相似文献
3.
掌握好膀胱镜检查技术 总被引:5,自引:0,他引:5
章咏裳 《中华泌尿外科杂志》1998,19(11):703-704
膀胱镜检查是诊断泌尿生殖系疾患的重要方法,泌尿外科医师一般都能熟练掌握。但对初学者说来,还应学习这种检查的基础知识,并积累膀胱镜检查的经验。一、膀胱镜的结构过去膀胱镜的光源来自镜鞘前端内腔的小型钨丝灯泡。镜鞘顶部有一金属小帽,约长15cm。小帽内装... 相似文献
4.
李金华 《临床泌尿外科杂志》1988,(2)
近几年来,随着肾移植、糖尿病和导管的使用增多,以及使用强免疫抑制剂使病人存活时间延长,泌尿生殖系真菌病逐渐增多。文献报道在有明确的尿路感染时真菌感染占2%,医源性尿路感染时占11%,败血症时占1.9%。感染途径为全身性真菌病血行播散或尿路上行感染.本病症状无特殊性,依其侵犯的泌尿生殖系部位而异。在泌尿生殖系中,肾真菌病最多见,其次为前列腺和附睾丸。 相似文献
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6.
李炎唐 《中华泌尿外科杂志》2003,24(7):465-465
郭应禄任名誉主编、李炎唐主编的《泌尿和男子生殖系创伤》一书于 2 0 0 3年 5月由人民军医出版社出版。全书共分 8章 ,从肾脏损伤、输尿管损伤、膀胱损伤、阴茎损伤、阴茎和阴囊内容物损伤、小儿泌尿生殖学的创伤治疗及泌尿生殖系战伤的处理等方面介绍了泌尿及男子生殖系创伤的原因、临床症状、体征、诊断及治疗措施 ;内容新颖 ,图文并茂 ,重视理论与实践的结合 ,参考了大量文献 ,具有较强的科学性和实用性。定价 2 8元 ,由全国新华书店发行。《泌尿和男子生殖系创伤》出版@李炎唐 相似文献
7.
目的:探讨泌尿生殖系平滑肌肿瘤临床表现,提高对其诊治水平。方法:对15例泌尿生殖系平滑肌肿瘤的临床资料进行回顾性分析,其中平滑肌瘤13例,平滑肌肉瘤1例,混合性平滑肌瘤1例(并发移行细胞癌),分别位于肾、输尿管、膀胱、尿道、附睾。肿瘤均手术切除,并经病理检查证实。结果:15例均获随访,13例平滑肌瘤术后无复发,1例平滑肌肉瘤术后16年无瘤生存,1例混合性平滑肌瘤至截稿时为术后2个月。结论:泌尿生殖系平滑肌肿瘤发生率低,以附睾多发,缺少临床特征,术前确诊困难,主要靠病理检查确诊。手术切除是治疗平滑肌肿瘤最佳方法。 相似文献
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9.
泌尿生殖系神经鞘瘤(附7例报告) 总被引:6,自引:2,他引:4
目的:探讨泌尿生殖系神经鞘瘤的临床、影像学及病理特点。方法:回顾性分析1994~2004年7例泌尿生殖系神经鞘瘤患者的临床资料,包括肾上腺、膀胱、前列腺、精索、阴囊及阴茎的神经鞘瘤,结合文献分析其特点。结果:患者平均年龄42岁,均为偶然发现或体检时发现,通过病理检查确诊。随访2~6年,7例患者肿瘤均经手术切除,病理证实6例良性,无复发;1例恶性睾丸神经鞘瘤,2年后死于肿瘤复发转移。结论:手术切除是目前治疗泌尿生殖系统神经鞘瘤的方法,由于泌尿生殖系神经鞘瘤缺乏典型的临床表现,临床诊断困难,确诊需经病理学诊断。肿瘤特异性标志物S100,Leu7及MBP有助于该病的诊断。 相似文献
10.
严庆惠 《国际泌尿系统杂志》1982,(3)
恶性淋巴瘤通常起始于淋巴结,但它可影响到机体几乎所有的器官。曾报导非何杰金氏淋巴瘤影响到泌尿生殖系较多,常为弥散性的肾实质浸润。局限于泌尿道的何杰金氏病报导较少。Watson等在383例何杰金氏病中发现仅5例有各种泌尿生殖系改变。作者回顾了1068例恶性淋巴瘤患者,包括各期淋巴瘤及很多局限性病变者。其中仅72例(6.74%)在尸检,放射照相或手术时有各种与淋巴瘤相关的泌尿系改变。在400例何杰金氏病中有23例(5.8%)、而668例非何杰金氏淋巴瘤中49例(7.3%)在病程的某 相似文献
11.
Multiple system atrophy (MSA) is an atypical parkinsonian disorder characterized clinically by the development of parkinsonism, autonomic dysfunction, corticospinal degeneration, and cerebellar abnormalities. The cause of MSA is unknown, and progression is usually faster than idiopathic Parkinson's disease. No treatment is currently available to prevent or slow the progression of this neurodegenerative disorder. Available treatments are primarily symptomatic. This article reviews the current treatment options available for MSA in addition to emerging therapies in neuroprotection and neurotransplantation. Research into the neuropathology of MSA is being conducted and could lead to new more effective treatments within the next decade. The management for this disorder currently includes symptomatic and palliative strategies, as well as family education and support; the ultimate goal is to improve the quality of life for patients and their caregivers. 相似文献
12.
Erectile and urinary dysfunction may be the presenting features in patients with multiple system atrophy: a retrospective study 总被引:2,自引:0,他引:2
Kirchhof K Apostolidis AN Mathias CJ Fowler CJ 《International journal of impotence research》2003,15(4):293-298
Multiple system atrophy (MSA) is a progressive neurodegenerative disease characterized by parkinsonism and cerebellar, autonomic, urinary, and/or pyramidal dysfunction. Urinary and erectile dysfunction (ED) symptoms are prominent early features in men with MSA. Autonomic failure, considered until recently to be the cause of ED in these men, is commonly expressed through symptoms of orthostatic hypotension (OH). The aim of this retrospective study is to examine the chronological relationship between the development of urogenital symptoms and those of OH in patients diagnosed with MSA and discuss its significance in the aetiology of ED in these patients. A total of 71 male patients, referred to a Uro-Neurology department with a diagnosis of 'probable MSA', were reviewed in terms of 'autonomic' symptoms only--OH and lower urinary tract symptoms, accompanied by ED--present at the time of their referral. Laboratory investigations including anal sphincter EMG and/or autonomic function tests (AFTs) were performed in 75 and 90% of the patients, respectively. At presentation, urinary complaints were recorded in 96% of patients and ED in all patients that this was inquired about. The onset of ED had preceded the onset of bladder symptoms in 58% and the onset of OH symptoms in 91% of these men. Bladder symptoms also preceded symptoms of OH in 76% of patients. Sphincter EMG was abnormal in 91% and AFTs in 77% of the patients tested. Almost all patients with abnormal EMG had troublesome urinary symptoms. AFTs showed similar sensitivity relating to symptoms. At presentation, urogenital symptoms are common in patients with probable MSA and are often not accompanied by symptoms of OH. The earlier occurrence of ED in men with MSA suggests a lack of a causal relationship to hypotension. The notion that MSA possibly affects the dopaminergic mechanism of erectile function is discussed. 相似文献
13.
Papatsoris AG Papapetropoulos S Singer C Deliveliotis C 《Neurourology and urodynamics》2008,27(1):22-27
Multiple system atrophy (MSA) is a neurodegenerative disease of undetermined etiology that occurs sporadically and manifests itself as a combination of parkinsonian, autonomic, cerebellar, and pyramidal signs. Despite the lack of effective therapies, some of the symptoms may be, at least temporarily, improved with adequate symptomatic therapies. Urinary and erectile dysfunction (ED) symptoms are prominent early features in male MSA patients. Lower urinary tract infections (UTIs) are a major cause of morbidity and mortality in this disorder. More than 50% of MSA patients suffer from recurrent lower UTIs and a significant number (approximately 25%) die of complications related to them. Urogenital symptoms in MSA are usually due to a complex mixture of central and peripheral nervous abnormalities, sometimes superimposed on previous local pathological conditions such as benign prostatic hyperplasia and perineal laxity. There have been instances were MSA-related urological symptoms were confused with symptoms of benign prostatic hyperplasia, leading to unnecessary urological surgery. In this review, we present the phenotypic range and therapeutic approaches for common storage and voiding urological symptoms and ED, in patients with MSA. 相似文献
14.
Y Kaiho T Namima K Uchi H Nakagawa M Aizawa Y Nishimura S Orikasa 《Nihon Hinyōkika Gakkai zasshi. The japanese journal of urology》1999,90(3):454-461
PURPOSE: Among spinocerebellar degeneration, syndromes categorized as multiple system atrophy (MSA) are commonly associated with neurogenic bladder, and urinary disturbances change with the disease progression. Accordingly, the changes in the urodynamic findings during the progression of the disease have been studied in the case of Olivopontocerebellar atrophy (OPCA) and OPCA type of MSA. METHODS: Urodynamic study (UDS) was performed more than twice in eight patients (5 males, 3 females, age 48-76, mean 55.0). The interval range between the first examination and follow up examination was 9-93 months (mean 42.4). UDS included cystogram, intravenous pyelography, residual urine volume, cystometry, urethral pressure profilometry, and external sphincter electromyography. RESULTS: The bladder was deformed in almost all patients with the progression of the disease, but the upper urinary tract was properly preserved. Residual urine volume tended to increase, and residual urine rate worsened significantly. The stable detrusor activity seemed to become overactive accompanied by detorusor hyperreflexia, and finally seemed to be acontractile. The normal sphincter activity seemed to become overactive accompanied by detrusor-sphincter dyssynergia, and finally complete relaxation could't be observed. CONCLUSION: These results suggest that urinary disturbance deteriorates together with other neuropathies as the disease progresses in OPCA. These patients should be continuously observed along with proper urinary management depending on the disease progression. 相似文献
15.
The value of urethral sphincter electromyography in the differential diagnosis of parkinsonism 总被引:10,自引:0,他引:10
I Eardley N P Quinn C J Fowler R S Kirby H F Parkhouse C D Marsden R Bannister 《British journal of urology》1989,64(4):360-362
A series of 54 patients presenting with parkinsonism underwent clinical assessment and urethral sphincter electromyography (EMG). After clinical assessment, 26 were thought to be suffering from probable multiple system atrophy (MSA), 15 were thought to have possible MSA and 13 were diagnosed as having probable idiopathic Parkinson's disease (IPD). Of those with probable MSA, 16 were found to have an abnormal urethral sphincter EMG. In the group with possible MSA, only 5 patients had an abnormal EMG while in the group with probable IPD, only 1 patient had an abnormal EMG. It was concluded that urethral sphincter electromyography provides a useful method of distinguishing between idiopathic Parkinson's disease and multiple system atrophy. It also provides a means of identifying those patients with parkinsonism whose incontinence may well be worsened, or in whom incontinence may develop following lower urinary tract surgery. 相似文献
16.
Diabetic neuropathy may manifest itself also in the autonomous nervous system and thus lead to a functional disorder of the urinary bladder. Urodynamic studies carried out in 11 diabetic patients with unclear bladder dysfunction allowed 2 forms of bladder anomalies to be identified: 1. detrusor hyperreflexia, 2. hyporeflexia and areflexia of the detrusor. Whereas hyperreflexia is clinically characterised by signs of motor urgency, hyporeflexia is mainly identifiable by residual urine formation and recurrent infections of the urinary tract. Therapy depends on the type of dysfunction and consists of physiotherapeutic measures, drug therapy and occasionally surgery. 相似文献
17.
Recent prospective, comparative ultrastructural/urodynamic studies on geriatric voiding dysfunction, including its natural evolution, have revealed that abnormalities of detrusor behavior have specific correlates in detrusor microstructure represented by distinctive electron-microscopic patterns. Each electron-microscopic pattern comprises a constellation of features in two or all three tissue compartments of the detrusor (smooth muscle, interstitium, intrinsic nerves). The pattern characteristic of each dysfunction is the same in detrusors of men and women. The electron-microscopic patterns are additive when multiple abnormalities coexist. All distinctive patterns of various clinical voiding dysfunctions can readily be defined qualitatively in endoscopic biopsies of the detrusor. These observations, including those on material studied for the natural evolution of geriatric voiding dysfunction, have led to the proposal of a clinical/structural definition of the normal aging detrusor and the development of an algorithm for pathologic diagnosis of geriatric voiding dysfunction. 相似文献
18.
OPINION STATEMENT: Sleep disorders in multiple system atrophy (MSA) are common manifestation and include reduced and fragmented sleep, excessive daytime sleepiness, REM sleep behaviour disorder (RBD), and sleep-disordered breathing. Of these, RBD is the most common (affecting 90?%-100?% of patients with MSA) and is regarded as a red flag for MSA. RBD, as well as stridor during sleep, may be the initial manifestation of the disease, occurring several years before the waking motor and dysautonomic onset. Sleep disorders occur in both MSA with predominant parkinsonism (MSA-P) and MSA with predominant cerebellar ataxia (MSA-C). Treatment strategies in patients with MSA presenting difficulties in initiating and maintaining sleep need to be highly individualized. Clonazepam has been found to be successful in treating RBD symptoms at the dose of 0.25 to 2.0?mg given approximately 30?min before bedtime. In case of comorbid obstructive sleep apnea, zopiclone (at the dose from 3.75 to 7.5?mg each night) or melatonin (with a recommended dose of 3 to 12?mg at bedtime) may be alternative treatments. An increased survival in MSA patients with stridor may be obtained both with continuous positive airway pressure (CPAP) and tracheostomy. Since tracheostomy is an invasive surgical procedure, not easily accepted by the patient, CPAP therapy should be considered first. However, tracheostomy is first indicated when stridor is present during wakefulness because of the high risk of respiratory failure and death. In MSA, obstructive sleep apnea (OSA) occurs more frequently than central sleep apnea, ranging from 15?% to 37?% of the cases. CPAP is an effective treatment for eliminating obstructive sleep apnea in MSA patients, even if the adaptation to the device may be difficult in advanced cases. 相似文献
19.
The urodynamic aspects of the Guillain-Barré syndrome 总被引:2,自引:0,他引:2
A total of 7 patients with the Guillain-Barré syndrome and voiding dysfunction, large post-voiding residuals or urinary retention underwent urodynamic evaluation. Of the patients 4 had detrusor areflexia with a positive bethanechol supersensitivity test, including 3 with electromyographic evidence suggestive of neuropathy. This is the expected pattern in the Guillain-Barré syndrome. However, 3 patients had detrusor hyperreflexia with appropriate sphincteric relaxation, which was associated with Babinski's sign in 2. The presence of detrusor hyperreflexia suggests the possibility of Guillain-Barré pathological conditions involving the central nervous system, although the Guillain-Barré syndrome typically is a disease of the peripheral nervous system. Long-term urodynamic studies may help clarify such issues in future patients. 相似文献
20.
Csar Galeano Bruno Jubelin Louis Germain Lilianne Guenette 《Neurourology and urodynamics》1986,5(1):45-63
We studied micturitional reflexes in 46 unanesthetized adult male cats spinalized at C5-C6 17 to 125 days previously and in eight intact central nervous system chloralosed cats that were used as controls. Urethral pressure profiles, cystosphincterograms with the urethrovesical junction opened and closed, and mechanograms of detrusor and circular and longitudinal urethral muscles were performed. The effect of vesical, urethral, pelvic, or pudendal anesthesia and vesical and urethral mechanical stimulation were studied. Our results suggest that spinalization produces two major types of neurourologic disorders: (1) weakness of detrusor contractor reflexes (vesicovesical and urethrovesical contraction reflexes) and (2) exaggeration of urethral contractor reflexes (urethrourethral contraction reflex, guarding reflex). Secondarily the weakness of detrusor contractions diminishes the efficiency of the urethral reflex relaxation needed for voiding (vesicourethral relaxation reflex). Because of these abnormalities, two main syndromes appear: (1) underactive detrusor function and (2) detrusor sphincter dyssynergia. Isolated peripheral manipulations of the bladder or urethra do not improve micturition: (1) increase in detrusor contraction strength induces detrusor sphincter dyssynergia, and (2) relaxation of the external sphincter facilitates voiding, but urinary retention persists. It is proposed that spinalization produces a central micturitional dysreflexia responsible for the peripheral dysfunction, and treatment must be oriented toward the central dysreflexia rather than the peripheral dysfunction. 相似文献