Shetty S D, al-Saigh A, Ibrahim A I, Patil K P, Bhattachan C L
Department of Surgery, College of Medicine, King Saud University (Abha branch), Saudi Arabia.
Br J Urol. 1992 Sep;70(3):258-61. doi: 10.1111/j.1464-410x.1992.tb15727.x.
Eleven patients with hydatid disease of the urinary tract have been seen in the last 5 years. Seven patients had cysts of the kidneys and 4 had large retrovesical hydatids. Seven of the 8 patients with renal hydatids presented with loin pain and mass. Three patients with renal communicating hydatids also presented with haematuria which was due to passing "grape skin" (hydatid membrane) in the urine. Two patients with retrovesical hydatids had bladder outflow obstruction and 2 had bilateral ureteric obstruction leading to uraemia. Eight of 11 patients had associated hydatids of other organs such as the liver (4 patients), peritoneal cavity (2) and lungs (1). Computed tomography was the most useful and specific investigation. In both renal and pelvic (retrovesical) hydatid cysts, endocystectomy with either partial excision or plication of the ectocyst is the standard treatment. In renal communicating hydatids the options are either nephrectomy (partial or total) or endocystectomy with closure of the communication. The use of cryocone and scolicidal agents is mandatory during surgery.
在过去5年里，共诊治了11例尿路包虫病患者。7例患者有肾囊肿，4例有巨大的膀胱后包虫。8例肾包虫患者中有7例表现为腰痛和肿块。3例肾交通性包虫患者还出现血尿，这是由于尿液中排出了“葡萄皮”（包虫膜）。2例膀胱后包虫患者出现膀胱流出道梗阻，2例出现双侧输尿管梗阻导致尿毒症。11例患者中有8例合并其他器官的包虫病，如肝脏（4例）、腹腔（2例）和肺（1例）。计算机断层扫描是最有用且最具特异性的检查方法。对于肾和盆腔（膀胱后）包虫囊肿，标准治疗方法是行内囊切除术，同时对外囊进行部分切除或折叠缝合。对于肾交通性包虫，可选择肾切除术（部分或全肾切除）或内囊切除术并封闭交通口。手术过程中必须使用冷冻探头和杀头节剂。
