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[完全性输尿管重复畸形合并前列腺癌中的结石:联合手术治疗]

[Lithiasis in complete ureteral duplication and prostate cancer: combined surgery treatment].

作者信息

Savino Mario, Musquera Mireia, Palou Juan, Prados Manuel, Salvador Josep, Villavicencio Humberto

机构信息

Servicio de Urologia, Fundació Puigvert, Universitat Autonoma de Barcelona, Barcelona, Spain.

出版信息

Arch Ital Urol Androl. 2003 Sep;75(3):158-60.

Abstract

The diagnosis of congenital anomalies of the urogenital tract in the adult is uncommon. Complete ureteral duplication represents a congenital anomaly of the ureters, usually draining a duplex kidney, with a second orifice entering the bladder, urethra or other structures. In the majority of cases, this pathology is completely asymptomatic; sometimes it's diagnosed because of complications such as infections, hydronephrosis, lithiasis, or in the evaluation of the urinary tract. Early diagnosis of localized prostatic adenocarcinoma is increased due to worldwide use of PSA screening and the optimization of multiple biopsy, increasing radical surgery treatments. The association between these two pathologies is a rare event. We present the case of a 69-years old man diagnosed for localized prostatic cancer and bilateral complete ureteral duplication, megaureter and stenosis of left superior ureteral meatus, leading in the prostatic urethra. Terminal ureter with the ectopic meatus opening in prostatic urethra was occupied by stones. A combined surgical procedure was undertaken: radical prostatectomy, ectopic ureter section, lithiasis removal and reimplantation of left ectopic ureter into the bladder. There is no case described of the association of this urogenital anomaly and prostate cancer and the combined management of both.

摘要

成人泌尿生殖道先天性异常的诊断并不常见。完全性输尿管重复畸形是一种输尿管先天性异常,通常引流双肾盂,第二个输尿管口进入膀胱、尿道或其他结构。在大多数情况下,这种病变完全没有症状;有时是因为感染、肾积水、结石等并发症或在评估泌尿系统时才被诊断出来。由于全球范围内使用前列腺特异性抗原(PSA)筛查以及优化多次活检,早期局限性前列腺癌的诊断有所增加,根治性手术治疗也随之增多。这两种病变之间的关联是罕见事件。我们报告一例69岁男性病例,该患者被诊断为局限性前列腺癌以及双侧完全性输尿管重复畸形、巨输尿管和左上输尿管口狭窄,其末端输尿管在前列腺尿道处开口异位且被结石占据。我们实施了联合手术:根治性前列腺切除术、异位输尿管切断术、结石清除术以及将左侧异位输尿管重新植入膀胱。目前尚未有关于这种泌尿生殖系统异常与前列腺癌关联以及两者联合治疗的病例报道。

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