肾及输尿管重复畸形伴输尿管囊肿1例

患者女,36岁."以间断性右下腹痛3个月,加重1个月"入院,既往无肾区绞痛,无尿频、尿急、尿痛及血尿等其他疾患.查体:右肾区压痛及叩击痛.     

经尿道输尿管囊壁部分切除术治疗成人输尿管囊肿11例临床分析

目的探讨经尿道输尿管囊壁部分切除术治疗成人输尿管口囊肿的治疗经验。方法回顾性分析11例成人输尿管口囊肿的临床资料。所有患者均采用B超、排泄性静脉尿路造影（IVU）及膀胱镜检查确诊，采用经尿道输尿管囊壁部分切除术治疗。结果11例患者手术治疗痊愈出院，术后临床症状均消失。随访6—24个月，9例肾积水消失，2例肾积水明显改善，未见复发。结论膀胱镜检查是诊断输尿管囊肿的确切手段；经尿道输尿管囊肿壁部分切除术是一种简便、安全和行之有效的治疗手段。     

Ectopic ureterocele in nonduplicated collecting systems

Ectopic ureteroceles in nonduplicated collecting systems are rare; only 34 well-documented cases have been reported in the English-language literature. We report two cases of a single-system ectopic ureterocele associated with a nonfunctional ipsilateral kidney in two boys. Nephroureterectomy and excision of the ureterocele were performed. One of the patients had a ventricular septal defect and the other had Sotos' syndrome. An ectopic ureterocele in a nonduplicated collecting system differs from a simple ureterocele or an ectopic ureterocele of a duplicated collecting system because of its prevalence in males, the frequent presence of a nonfunctional ipsilateral kidney, and the high incidence of associated anomalies such as congenital heart disease, crossed renal ectopia, and vas deferens abnormalities. Offprint requests to: R. Gonzalez     

输尿管囊肿的影像学诊断与早期处理(附7例报告)

目的：探讨输尿管囊肿的诊断与治疗方案。方法：回顾性分析7例输尿管囊肿患者的临床资料，3例采用三角区重建术治疗，2例行经尿道囊肿低位横切开术，1例外院行经尿道囊肿切开术后反流患者行输尿管再植术，1例行重复上半肾及输尿管切除术。结果：7例患者均获治愈，随访6个月～11年，无并发症发生。结论：输尿管囊肿主要依靠影像学诊断；手术处理宜早期进行，输尿管口囊肿切除、三角区重建术是一种好的术式；输尿管反流和泌尿系感染是各种治疗不应忽视的问题。     

输尿管膨出44例报告

目的 :探讨提高对输尿管膨出的诊断和治疗水平的方法。方法 :总结 16年收治的 4 4例患者临床资料。术前行B超、IVP、CT或膀胱镜检查。 2 4例行膨出部切除加膀胱输尿管再吻合术 ,其中 8例同时切除了同侧上肾和输尿管。 2 0例行经尿道内腔镜囊肿切开治疗。结果 :B超和IVP两种检查结合可明显提高诊断符合率 ,膀胱镜检的准确率可达 10 0 %。随访 1～ 16年 ,其中 1例患者有待接受第二次手术 ,所有患者术后症状改善 ,复查显示积水消失 ,无尿液反流。结论 :B超和IVP是理想而必要的检查 ,对手术方法的选择有指导意义。治疗以手术为主 ,并发有重复肾输尿管畸形或输尿管膨出部巨大 (直径 >3cm)的病例 ,宜行上肾及输尿管切除或 (和 )膨出部切除加输尿管膀胱再吻合术。成人单纯型输尿管膨出 ,可优先考虑内腔镜治疗     

Bilateral intravesical ureterocele associated with unilateral partial duplication of the ureter and other anomalies: proposal of a new variant to the classification of ureterocles based on a perinatal autopsy,review of the literature and embryology

Jaiman S, Ulhøj BP. Bilateral intravesical ureterocele associated with unilateral partial duplication of the ureter and other anomalies: proposal of a new variant to the classification of ureterocles based on a perinatal autopsy, review of the literature and embryology. APMIS 2010; 118: 809–14. The aims of this study were to demonstrate a case of bilateral intravesical ureterocele associated with megacystis and mega‐ureters, unilateral partial duplication of the ureter and unilateral segmental renal dysplasia of the upper pole and an accessory spleen and to propose an addition of the new variant to the classification of ureteroceles. A perinatal necropsy was conducted on the 21‐week fetus by employing the Rokitansky procedure with evisceration performed in blocks. The autopsy revealed the aforementioned abnormalities without cardiac or neural anomalies. The amniocentesis report was normal. Ureterocele is a saccular expansion of the distal ureter. It is most commonly observed in females and children and usually affects the upper moiety of a complete pyeloureteral duplication. Four types of ureteroceles are described: (A) ureterocele with single ureter (10%); (B) ureterocele with total duplication and intravesical development (10%); (C) ureterocele with total duplication and extravesical development (62%); and (D) ureterocele with ectopic ureter (3%). One case in a new born with bilateral intravesical ureterocele associated with hydrouretero‐nephrosis and hyperechogenic spots in kidneys has been reported, but bilateral intravesical ureterocele with unilateral incomplete pyeloureteral duplication has never been described in the literature.     

Prenatal ultrasonographic features of persistent urogenital sinus with hydrometrocolpos and ascites

Objective  Hydrometrocolpos is a rare congenital disorder very rarely reported on prenatal sonography. In this study we report a persisten urogenital sinus with hydrometrocolpos and ascites at 24 weeks of gestation. Case  Detailed ultrasonographic examination revealed female fetus with pelvic mass measured as 60 × 70 × 80 mm, anterior to sacral bone and inferior to bladder, and ascites, ureterocele, hydoureters, hydronephrosis but normal amniotic fluid. Further examination showed that cervical canal and uterin cavity was in continuation with the pelvic mass and dilatation of uterine tubes implicated hydrometrocolpos. Physical examination of the neonate revealed a single anterior opening at perineum and a patent anus but no visible urethral orifice. A voiding cystourethrogram demonstrated a urethrovaginal fistula. The neonate underwent ureteroneoostomy and was discharged on day 10 for follow-up and final repair. Conclusion  Prenatal ultrasonographic diagnosis of hydrometrocolpos in our case prevented unnecessary interventions and allowed early neonatal treatment.     

采用导引钢丝进行儿童膀胱镜经尿道电切治疗

目的 介绍采用导引钢丝进行膀胱镜经尿道的后尿道瓣膜和输尿管囊肿电切方法。方法21例后尿道瓣膜和13例输尿管囊肿患儿,应用外套3Fr输尿管导管的导引钢丝在膀胱镜直视下经尿道进行瓣膜或囊肿电切。结果电切所用时间为15～20min。21例后尿道瓣膜患儿术后排尿性膀胱尿道造影复查显示瓣膜完全消失,无尿道狭窄;13例输尿管囊肿患儿术后B超显示囊肿均已消失。结论采用导引钢丝进行膀胱镜经尿道电切手术安全、有效、简便、迅速,适用于儿童尤其是新生儿和婴幼儿后尿道瓣膜或输尿管囊肿的治疗。     

Double collecting system with ectopic ureterocele masquerading as an ovarian torsion

Objective

Ureterocele in a duplex system is rare and commonly presented with urinary tract infection at neonatal age, infant or childhood. Symptomatic ureterocele in reproductive-age is a diagnostic challenge and should be highly awarded to avoid miss-diagnosis.