尿路子宫内膜异位症的诊断及治疗

Diagnosis and treatment of urinary tract endometriosis

目的探讨尿路子宫内膜异位症(endometriosis,EMS)的诊断及治疗。方法总结12例尿路EMS的临床特点、诊断、治疗及随访情况。结果12例EMS患者中,膀胱EMS7例,输尿管EMS5例,所有病例均经病理证实;7例膀胱EMS均行膀胱部分切除术,5例输尿管EMS中,2例行经输尿管镜激光治疗,1例行输尿管部分切除及输尿管膀胱再植术,2例行输尿管部分切除、输尿管-输尿管端端吻合术。结论尿路EMS常无特异性症状,但可造成肾功能损害,值得重视;出现尿路梗阻时,及时手术治疗,可取得良好效果。

Objective To study the diagnosis and treatment of urinary tract endometriosis （EMS）. Methods 12 cases of urinary tract endometriosis were reviewed. Their clinical features, diagnosis and treatment were analyzed. Results In these 12 cases, 7 were bladder EMS and 5 were ureter EMS. The diagnosis of all cases was confirmed by pathological evidences. The treatments included partial cystectomy, partial ureteral wall resection and ureteroureterostomy, ureterovesiculostomy, and laser therapy through ureteroscopy. All patents were followed up for 6 months to 12 years. No recurrence occurred. Conclusion Endometriosis of urinary bladder and ureter can present without causing any specific symptom. However, it can silently damage renal function. Attention should be paid to ureteral obstruction caused by endometriosis.