Woodhouse C R, Lennon G N
Institute of Urology, 48 Riding House Street, London W1P 7PN, UK.
Eur Urol. 2001 Mar;39(3):253-9. doi: 10.1159/000052448.
To review the aetiology and management of reservoir stones in patients with intestinal urinary reservoirs.
Since 1983 patients with enterocystoplasty have been followed prospectively by protocol. The data sets and notes of 148 patients reconstructed for congenital anomalies were reviewed to retrieve information on the incidence, management and aetiology of reservoir stones.
Data were complete on 146 patients, 2 others having been lost to follow-up. Mean follow-up was 3.4 (range 1-14) years. Twenty-three patients formed stones (15.8%). Mean time to stone formation was 45 months (range 1 month to 10 years). In 13 patients the stones were removed by a percutaneous approach. In 9 patients with large stones (>5 cm) an open removal was performed. One patient had a small stone removed through a Kock nipple. All stones were struvite on analysis. All patients with an augmented bladder drained by a supra-pubic Mitrofanoff formed stones at some time. The incidence of stones in other groups was: Kock pouch 50%; reservoirs drained by urethral catheterisation 9%; all other abdominal reservoirs 7.5%. No patient who voided spontaneously formed stones.
Reservoir stones are infective in composition. The incidence is strongly related to the lack of downward, gravitational emptying. Stones up to 5 cm can be removed percutaneously.
回顾肠代膀胱患者储尿囊结石的病因及处理方法。
自1983年起，对接受肠膀胱扩大术的患者按照方案进行前瞻性随访。回顾了148例因先天性异常而接受重建手术患者的数据集和病历，以获取有关储尿囊结石的发病率、处理方法及病因的信息。
146例患者资料完整，另外2例失访。平均随访时间为3.4年（范围1 - 14年）。23例患者形成结石（15.8%）。结石形成的平均时间为45个月（范围1个月至10年）。13例患者经皮取出结石。9例结石较大（>5 cm）的患者采用开放手术取出。1例患者通过Kock乳头取出小结石。经分析，所有结石均为磷酸镁铵结石。所有通过耻骨上Mitrofanoff导管引流的膀胱扩大术患者均在某一时刻形成结石。其他组结石的发病率为：Kock囊50%；经尿道导管引流的储尿囊9%；所有其他腹部储尿囊7.5%。无自主排尿患者形成结石。
储尿囊结石成分与感染有关。发病率与缺乏重力作用下的向下排空密切相关。直径达5 cm的结石可经皮取出。
