经尿道内窥镜手术治疗输尿管膨出

Operation Treatment of Ureterocele with Transurethral Endoscopic

目的:探讨经尿道内窥镜手术切除输尿管膨出的治疗效果。方法:回顾性分析11例成人输尿管膨出患者采用经尿道内窥镜手术治疗的临床资料。结果:11例患者均经IVU、B超及膀胱镜检查确诊,采用电切镜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;7例行输尿管膨出囊壁部分切除术,积水全部消失。11例手术均一次手术成功,术后平均随访19mo,3例术后出现输尿管反流,2例2mo后自行缓解,1例术后3mo行开放手术抗反流。结论:经尿道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。经尿道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 explore clinical effect of ureterocele with transurethral endoscopic operation. Methods： Retrospective analysis of 11 cases with ureterocele treated by transurethral endoscopic. Results： All patients were diagnosed by IVU, ullrasonography and cystoseopy. 4 cases were operated with transurethral incision of ureterocele and 7 cases with transurethral unroofing. No hydronephrosis were found after operation in 8-28 months follow-up for all patients. 1 ease had vesicoureteral reflex at 3 months after operation and then accepted open surgical. Conclusions： It is a method of simple, effective and safe that ureterocele with transurethral endoscopic operation. It brings on minimal trauma, faster renew and decrease complications. The operation of transurethral unroofing is more ideality. Surgical should be considered while vesicoureteral reflex happened.