Cetinel B, Akpinar H, Tüfek I, Uygun N, Solok V, Yazici H
Department of Urology, Istanbul University, Cerrahpaşa School of Medicine, Turkey.
J Urol. 1999 Jan;161(1):52-6.
We report our clinical experience with Behçet's syndrome and bladder involvement.
From April 1991 through July 1996, 7 men and 1 woman 25 to 53 years old with Behçet's syndrome were evaluated for lower urinary tract symptoms (7) or hematuria (1). Of 8 patients 5 had neurological involvement. Evaluation consisted of history, physical examination, urinalysis and urine culture, excretory urography, urodynamic studies, urethrocystoscopy, bladder biopsies and histopathological examination.
Cystoscopy revealed bladder ulcer in 1 patient and an indurated, hypervascular lesion in another with bilateral hydronephrosis. The most common urodynamic finding was detrusor overactivity. Of 4 patients with poor compliance 1 had additional sphincteric deficiency. Common histopathological features were moderate and marked thickening of bladder vessel walls. Lymphocytic vascular reaction was present in 2 patients and lymphocytic vasculitis in 1. Clamshell augmentation ileocystoplasty was performed in 3 patients, including 1 who also underwent a sphincter enhancement procedure. The remaining 5 patients received various nonsurgical treatment.
Various types of voiding dysfunction relating to bladder and sphincteric components in both phases of micturition can be seen in Behçet's syndrome. Voiding dysfunction can be due to either neurological or direct bladder involvement. Augmentation ileocystoplasty is a good treatment option for Behçet's syndrome with severe bladder involvement.
我们报告白塞氏综合征合并膀胱受累的临床经验。
1991年4月至1996年7月，对7名年龄在25至53岁的男性和1名女性白塞氏综合征患者进行了评估，他们因下尿路症状（7例）或血尿（1例）前来就诊。8例患者中有5例伴有神经受累。评估包括病史、体格检查、尿液分析和尿培养、排泄性尿路造影、尿动力学研究、尿道膀胱镜检查、膀胱活检及组织病理学检查。
膀胱镜检查发现1例患者有膀胱溃疡，另1例有硬结、血管增多的病变，伴有双侧肾积水。最常见的尿动力学表现是逼尿肌过度活动。4例顺应性差的患者中，1例还存在括约肌功能不全。常见的组织病理学特征是膀胱血管壁中度和显著增厚。2例患者出现淋巴细胞血管反应，1例出现淋巴细胞性血管炎。3例患者接受了蛤壳式回肠膀胱扩大术，其中1例还接受了括约肌增强手术。其余5例患者接受了各种非手术治疗。
白塞氏综合征患者在排尿的两个阶段均可出现与膀胱和括约肌成分相关的各种类型的排尿功能障碍。排尿功能障碍可能是由于神经受累或膀胱直接受累所致。回肠膀胱扩大术是白塞氏综合征严重膀胱受累的一种良好治疗选择。
