小儿输尿管开口异位的诊断和治疗(附22例报告)

目的 提高小儿输尿管开口异位的诊治效果。方法 总结22例输尿管开口异位患儿临床资料。男1例，女21例。年龄1个月～12岁，平均4岁。单侧17例，双侧5例。21例女童中，有正常分次排尿伴异常漏尿18例，完全持续性漏尿3例；1例男童有上尿路梗阻及泌尿系感染。异位开口于阴道14例、尿道4例、前庭3例、膀胱颈1例。结果 手术治疗20例，其中肾切除者11例、半肾切除者7例，术后漏尿症状消失，3例合并输尿管残端综合征；1例双输尿管膀胱再植术后仍有尿失禁；1例直肠化膀胱术无漏尿症状。结论 明确诊断，选择合理手术是小儿异位输尿管口治疗成功的关键。

Diagnosis and treatment of ectopic ureter in children (report of 22 cases)

Objective To summarize the experience in diagnosis and treatment of ectopic ureter in children. Methods A total of 22 cases (21 females and 1 male;mean age of 4 years,range from 1 month to 12 years) of ectopic ureter were analyzed retrospectively.Of them,17 cases had unilateral ectopic ureters and 5,bilateral.Normal,divided urination accompanied by abnormal leakage of urine occurred in 18 cases;completely continous leakage of urine in 3;and obstruction of upper urinary tract with infection of urinary system in 1.Fourteen cases had opening of ectopic ureters in vaginas,4 in urethras,3 in vestibula and 1 in bladder necks. Results Of the 22 cases 20 underwent surgical procedures.Of the 20 cases,11 had total nephrectomy and 7,partial nephrectomy.After the operation,leakage of urine disappeared,but 3 cases had syndrome of ureteral stump remnant.One case who underwent bilateral ureter-bladder reimplantation had mild urinary incontinence after the operation.One case who had vesica replaced with rectum was followed up for 5 years,the post-operative result was excellent. Conclusions It is of critical importance to establish definite diagnosis and to select appropriate mode of operation for the successful treatment of ectopic ureter in children.