Grande Moreillo C, Rodó Salas J, Morales Fochs L
Servicio de Cirugía Pediátrica, Unitat Integrada, Hospital Sant Joan de Déu/Hospital Clinic, Universitat de Barcelona, Barcelona.
Actas Urol Esp. 2000 Apr;24(4):314-8. doi: 10.1016/s0210-4806(00)72454-5.
Continuous urine dripping together with normal micturition is the classical picture of ectopic ureter in girls. During the years 1982 to 1996, eleven girls with such abnormality have been treated at our department. The diagnostic work-up included: intravenous pyelogram (IP), ultrasonography (US), renal scintiscan, cystogram, cystoscopy and/or vaginoscopy, as well as a thorough exam of the external genitalia under general anesthesia. Ten girls had a double renal system, one of them being bilateral; one girl had simple kidneys with renal ectopia. Treatment was heminephrectomy with ureterectomy in 9 cases, ureteroureterostomy with preservation of the hemikidney in one case, and nephrectomy with ureterectomy in the case with a simple system. Urinary incontinence in girls due to ectopic ureter is an uncommon disease. Eigthty-five% of the cases are associated to renal duplication. IP is highly sensible to defect renal duplication; direct vision of the ectopic ureter meatus, canalization and roentgenologic confirmation of the suspected diagnosis are required prior to surgery. Heminephrectomy has been the most common treatment; however, early diagnosis by means of US will promote more conservative surgical approaches.
持续性滴尿伴正常排尿是女孩异位输尿管的典型表现。1982年至1996年间,我科共治疗了11例有此类异常的女孩。诊断检查包括:静脉肾盂造影(IP)、超声检查(US)、肾闪烁扫描、膀胱造影、膀胱镜检查和/或阴道镜检查,以及在全身麻醉下对外部生殖器进行全面检查。10名女孩有重复肾系统,其中1例为双侧;1名女孩有单纯肾伴肾异位。9例行半肾切除术加输尿管切除术,1例行输尿管输尿管吻合术并保留半肾,1例单纯肾系统者行肾切除术加输尿管切除术。女孩因异位输尿管导致的尿失禁是一种罕见疾病。85%的病例与重复肾有关。IP对肾重复畸形高度敏感;手术前需要直接观察异位输尿管口、进行输尿管插管并通过放射学方法证实疑似诊断。半肾切除术一直是最常见的治疗方法;然而,通过超声进行早期诊断将促使采取更保守的手术方法。