输尿管口囊肿的微创手术治疗

目的评价输尿管口囊肿的微创手术治疗方法及其疗效。方法回顾性分析25例行经尿道电切（TURU）手术治疗输尿管口囊肿患者资料。男9例，女16例；年龄18—61岁，平均38岁；单侧18例，双侧7例；单纯输尿管囊肿22例，异位输尿管囊肿3例。结果25例患者手术一次成功22例，手术平均时间15min，术后平均住院3d。术后定期B超、膀胱造影随诊，随诊时间1—9年，3例异位输尿管囊肿合并重复肾、输尿管畸形患者存在术后膀胱输尿管返流，2例再次行开放手术后痊愈。结论TURU是治疗成人输尿管口囊肿的有效方法；当合并存在重复肾输尿管畸形或术后膀胱输尿管返流时，应采用输尿管膀胱抗返流手术。     

小儿输尿管膨出症的治疗

目的探讨各种方法治疗输尿管膨出症的疗效,寻找影响预后的有关因素。方法 31例输尿管膨出症,男4例,女27例;左侧15例,右侧12例,双侧4例。其中单一输尿管膨出2例,重肾并输尿管膨出29例。VCU检查18例,3例发现中—重度反流,31例均行超声和IVU及CT检查。结果术后随访0.5～3 a,2例单一输尿管膨出症行膨出切除输尿管膀胱再植术,29例重肾中,4例经膀胱行输尿管膨出切除输尿管膀胱再植术。3例中—重度反流,2例行输尿管膨出切除加上半肾切除术,1例行上半肾切除术,术后因反流持续存在,需再次手术;其余22例均行上半肾切除术,术后2例因严重尿路感染行输尿管残端切除术。结论输尿管膨出的治疗应根据输尿管膨出的类型、肾功能、有无反流决定手术方式,对于大多数重肾,单纯上半肾切除预后良好,若术前VCU检查有中—重度返流,应行完全重建术。     

成人输尿管口囊肿的诊断及治疗

目的:探讨成人输尿管口囊肿的诊断及治疗方法。方法:回顾性分析12例成人输尿管口囊肿的临床资料。12例患者均采用B超、IVU及膀胱镜检查,3例采用三角区重建术,9例行经尿道囊肿低位横切术。结果:12例患者治愈,随访1~5年无并发症发生。结论:输尿管口囊肿主要靠影像学诊断,三角区重建术及经尿道低位横切术是一种较理想的术式,术后随访是各种治疗不可忽视的问题。     

经尿道等离子电切治疗成人输尿管开口囊肿(附12例报告)

目的观察经尿道等离子电切治疗成人输尿管开口囊肿的效果。方法回顾性分析12例成人输尿管囊肿患者采用经尿道等离子电切治疗的临床资料。结果12例患者均经IVU、B超及膀胱镜检查确诊,采用经尿道等离子电切行输尿管囊肿低位横行切开术4例,3例肾积水消失,1例肾积水改善;8例行输尿管膨出囊壁部分切除,积水全部消失。均一次手术成功,术后平均随访8个月,2例术后出现输尿管返流,均于3个月后自行缓解。结论经尿道等离子电切治疗成人输尿管开口囊肿是一种安全、简单、有效的治疗方法,可以减少手术创伤及术后并发症,创伤小、恢复快。囊壁部分切除术效果更为理想。     

成人输尿管囊肿的影像学表现(附12例报告)

目的:探讨成人输尿管囊肿的影像学表现,提高对其认识。材料与方法:收集经X线、CT、MRI及B超检查发现,并经膀胱镜、手术证实的12例成人输尿管囊肿,进行回顾性分析、研究,并复习相关文献及资料。结果:囊肿多局限于输尿管下段,单侧或双侧;“眼镜蛇头”征或“光晕征”为其特征性表现;MRI检查可确定囊肿的真实范围,但在定性诊断上不如增强后CT;B超检查经济、方便、快捷、无创伤,应作为发现病例的首选方法。结论:结合各种影像检查表现,可对成人输尿管囊肿作出正确诊断,静脉尿路造影(IVU)及排尿期膀胱造影检查对临床制定合理的手术方案具有重要意义。     

输尿管囊肿的超声诊断

目的通过7例输尿管囊肿的超声表现,探讨超声对输尿管囊肿的诊断价值。方法患者膀胱中度充盈状态下,取仰卧位,耻骨联合上区行腹部超声探查,观察输尿管囊肿的形态及动态变化特征。结果超声能清楚的显示输尿管囊肿的位置、形态及图像特点,诊断输尿管囊肿的特异性为100%。结论经腹超声诊断输尿管囊肿的敏感性、准确率高,具有确诊价值。     

Endoscopic and minimal open surgical incision of ureteroceles

Ureterocele decompression by endoscopic or open incision was the primary treatment in 59 children with 63 ureteroceles. Of these, 18 were intravesical and 45 were ectopic. The endoscopic or open incision adequately decompressed all intravesical ureteroceles and 37 of 45 ectopic ureteroceles (82%). After incision, the secondary operation rate was 17% for intravesical and 62% for ectopic ureteroceles. In our opinion, endoscopic or open incision must be considered a definitive treatment in the large majority of intravesical ureteroceles and is also valid in ectopic ureteroceles. In these cases, the early decompression obtained by this approach produced significant functional recovery, fewer urinary tract infections, and facilitated subsequent surgery in those patients requiring complete surgical reconstruction. Accepted: 11 June 1997     

Forniceal rupture secondary to ureterocele and increased urine flow

A case of a simple ureterocele presenting with spontaneous forniceal rupture is described. Rupture followed hypophysectomy for Cushing’s disease and high urine outflow. This presentation has not been reported previously.