Deng Cheng-yan, Yu Qi, Lian Li-juan
Department of Gynecology and Obsterics, PUMC Hospital, CAMS, PUMC, Beijing 100730, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2002 Feb;24(1):59-62.
Aimed at illustrating the means of early diagnosis for prevention of the impairment of kidney function, the results of conservative medical therapy and the surgical treatment in patients with endometriosis of urinary tract.
Surgical interventions were done in 5 cases with pathological of endometriosis. Ureters were involved by endometriotic lesion in 3 patients, ureters and bladder in one and urethra in another patient. All of the cases were shown at least partial obstruction of the urinary tract by clinical symptoms, diagnostic examinations and the outcomes of various kinds of treatment.
Hydropnephrosis and hydroureter were shown by ultrasonography, IVP or retrograde pyelography in one case of ureteral obstruction. A small lump of endometriotic foci along the urethra was detected by manual examination and ultra-sonography in one patient. The relieving of the symptoms and signs of the obstruction of the urinary tract in two cases by GnRH-a or progest in was the evidence of the endometriotic lesion. There were two patients underwent surgical resection of the endometriotic foci surrounding the ureter after medical therapy.
Urinary tract endometriosis are rarely seen and usually escape the attention of the physicians, while they usually cause obstruction of the urinary tract and finally impairment of kidney function if not treated in time. This kind of disease can be easily diagnosed by imaging detection with ultra-sonography, IVP or retrograde pyelography. Conservative treatment with GnRH-a and long acting progesterone as well as surgical treatments are effective for this kind of disease.
旨在阐明早期诊断方法以预防肾功能损害，以及介绍尿路子宫内膜异位症患者的保守药物治疗和手术治疗结果。
对5例患有子宫内膜异位症病理改变的患者进行了手术干预。3例患者的输尿管受子宫内膜异位病变累及，1例输尿管和膀胱受累，另1例尿道受累。所有病例经临床症状、诊断检查及各种治疗结果显示至少存在部分尿路梗阻。
1例输尿管梗阻患者经超声、静脉肾盂造影（IVP）或逆行肾盂造影显示肾盂积水和输尿管积水。1例患者经体格检查和超声检查发现沿尿道有一小片子宫内膜异位病灶。2例患者经促性腺激素释放激素激动剂（GnRH-a）或孕激素治疗后尿路梗阻症状和体征缓解，证明存在子宫内膜异位病变。2例患者在药物治疗后接受了输尿管周围子宫内膜异位病灶的手术切除。
尿路子宫内膜异位症罕见，常易被医生忽视，若不及时治疗，通常会导致尿路梗阻，最终造成肾功能损害。这种疾病通过超声、IVP或逆行肾盂造影等影像学检查易于诊断。GnRH-a和长效孕激素的保守治疗以及手术治疗对这种疾病有效。
