苗勒管囊肿15例的诊治探讨

Diagnosis And Treatment of Mullerian Duct Cyst

目的介绍本院15年来对苗勒管囊肿的诊断及治疗经验。方法1990年￣2004年共收治苗勒管囊肿患儿15例,其中6例为正常男性外生殖器的苗勒管囊肿,9例伴有尿道下裂。年龄5个月￣13岁。主诉为脓尿6例,湿裤1例,腹部包块2例,反复发作性附睾炎6例。体检时有12例于直肠前壁或腹部触及肿块。15例经B超、CT或MRU影像学检查提示膀胱后囊性占位性病变。9例经下腹部切口腹膜外径路行囊肿切除术,5例在腹腔镜下作囊肿切除,1例因术前囊肿巨大,诊断未确定,作腹部探查手术。结果15例患儿术后症状、体征均消失,随访1￣14年囊肿未见复发。结论苗勒管囊肿患儿常伴有反复尿道感染、附睾炎、排尿困难或腹部包块等症状,B超、CT或MRU影像学检查可以确诊,但需与重复膀胱、膀胱憩室、精囊囊肿等相鉴别,经耻骨上腹膜外径路或腹腔镜下作囊肿切除术能达到根治的目的。

Objective To introduce the diagnosis and management of Mullerian duct cyst. Methods Fifteen patients with Mullerian duct cyst were treated from 1990 to 2004 in our hospital. Their age range from 5 months to 13 years （mean, 5.5 year）. Six patients chief complaint with pyuria, two with wetting, two with abdominal palpable mass and six with recurrent epididymitis attack. The cysts were palpable on abdominal or rectal examination. Ultrasound, CT, and MRU examinations showed a rectovesical cyst. Nine cysts were removed via transverse lower abdominal incision extraperitoneally. One was removed intraperitoneally. Five were resected by laparoscopy. Rseults These children were followed-up for 1-14 years without replase. Conclusion The Mullerian duct cyst in children can present with as recurrent urinary tract infection differential, epididymitis, abdominal mass or dysuria. The diagnosis is established by ultrasound, CT or MRU examination, but it needs to differential diagnose from duplicate bladder, bladder diverticulum, seminal vestcle cysts. The cysts can be resected via eratically superpubic extraperitoneal route or by laparoscopy.