成人输尿管囊肿的诊断和治疗（附32例报告）

The Diagnosis and Treatment of Ureterocele in Adults：Report of 32 Cases

目的探讨成人输尿管囊肿的诊断及治疗方法。方法回顾性分析2008年08月～2013年03月收治的32例成人输尿管囊肿患者的临床资料。所有病例均经B超、静脉肾盂造影（IVP）和膀胱镜检查确诊，分别给予观察随访、开放手术或者经尿道输尿管囊肿电切开术（TUIU）治疗。结果膀胱镜诊断符合率为100％（32／32），IVP诊断符合率87．5％（28／32），B超诊断符合率78．1％（25／32）。1例观察随诊，2例行开放手术，其余29例行TUIU术。术后随访3～28个月，患者临床症状和肾积水消失或减轻，无膀胱输尿管反流发生。结论TUIU是治疗成人输尿管囊肿的一种有效且重要的方法。对于合并严重的重复肾、输尿管畸形者宜采用开放性手术，并行输尿管再植术，防止术后膀胱输尿管反流。

Objective To study the diagnosis and treatment of ureterocele in adults.Methods A total clinical documents of 32 cases of ureterocele in adults were analyzed retrospectively in our hospital during August 2008 and March 2013.Diagnosed confirmedly by IVP, ultrasonography and cystoscopy, all the cases were then given follow- up,open surgery and TUIU respectively.Results The accurate diagnosis rate of cystoscopy, IVP and ultrasonography has been 100%,87.5% and 78.1% respectively. 1 was given followed up,2 open surgeries and the rest transurethral incision of ureteroceles（TUIU）.Follow-up ranged from 3 to 28 months with regular B-ultrasonography and cystoscopy then the clinical symptoms and the hydronephrosis disappeared or relieved and no vesicoureteral reflux occurred.Conclusion TUIU is an effective and primary operative procedure for ureterocele in adults,whereas those with concomitant renal and ureteral duplication should be treated by transvesical excision and re-implantation in avoidance of postoperative vesicoureteral reflux.