内窥镜手术治疗输尿管膨出13例报告

Transurethral endoscopic management of ureterocele (Report of 13 cases)

目的:观察内窥镜手术切除输尿管膨出的治疗效果。方法:回顾性分析 13 例成人输尿管膨出患者采用内窥镜手术治疗的临床资料。结果:13例患者均经 IVU、B超及膀胱镜检查确诊,采用电切镜或钬激光机行输尿管囊肿低位横行切开术5例,3例肾积水消失,2 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18个月,3例术后出现输尿管反流,2 例 2 个月后自行缓解,1 例于术后 4个月行开放手术抗反流。结论:内窥镜手术切除输尿管膨出是一种安全、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。当输尿管反流不能自愈时,应行输尿管膀胱抗反流吻合术。

Objective:To evaluate the clinical efficacy of transurethral endoscopic management of 13 cases of ureterocele in the adult.Methods:Clinical data of 13 cases of ureterocele treated via endoscopy from 1993 through 2003 were analyzed retrospectively.Results:The diagnosis of all cases were confirmed by ultrasonography、IVU and cystoscopy preoperatively. Transurethral incision of ureterocele was undertaken in 5 cases, and transurethral unroofing in the other 8 cases. No hydronephrosis were found after 6~26 month's follow-up in all the cases. One patient was noted having vesicoureteral reflux at 4 months after operation and then received open surgery.Conclusions:Transurethral intervention of ureterocele is simple and effective with minimal trauma. Transurethral unroofing is a safe and effective procedure for the treatment of ureterocele. Operative surgery should be considered while vesicoureteral reflux noted.