Chin J L
Division of Urology, University Hospital, University of Western Ontario, London, Canada.
J Urol. 1992 Apr;147(4):987-9. doi: 10.1016/s0022-5347(17)37442-6.
The loin pain-hematuria syndrome is a poorly understood constellation of symptoms consisting of persistent hematuria and intractable loin pain with negative comprehensive urological evaluation. The patients are severely debilitated by the pain and are usually dependent on narcotics. Various medical and surgical treatments have been tried unsuccessfully, ultimately leading to nephrectomy in many instances. The symptoms may subsequently occur contralaterally. Renal autotransplantation as a form of nephron-sparing denervation therapy for relief of pain was performed on 12 kidneys in 10 patients (2 bilaterally). Excluding 3 patients with followup of less than 1 year (all 3 are pain-free), 8 of the 9 autotransplantations have resulted in dramatic relief of pain, curtailment of narcotic use and return of the patient to normal daily function. Median followup was 43 months (range 15 to 53 months). The remaining patient had pain in the graft area necessitating transplant nephrectomy 4 months later. For patients severely affected by pain and narcotic dependence with this syndrome, renal autotransplantation may provide a nephron-sparing surgical solution.
腰背痛-血尿综合征是一组症状，目前对此了解甚少，其症状包括持续性血尿和顽固性腰背痛，而全面的泌尿系统评估结果为阴性。患者因疼痛而严重衰弱，通常依赖麻醉药品。已经尝试了各种医学和外科治疗方法，但均未成功，最终在许多情况下导致肾切除术。症状随后可能会在对侧出现。对10例患者的12个肾脏（2例为双侧）进行了肾自体移植，作为一种保留肾单位的去神经疗法以缓解疼痛。排除3例随访时间少于1年的患者（这3例均无疼痛），9例自体移植中有8例使疼痛得到显著缓解，减少了麻醉药品的使用，患者恢复了正常的日常功能。中位随访时间为43个月（范围15至53个月）。其余1例患者移植部位疼痛，4个月后需要进行移植肾切除术。对于受该综合征疼痛和麻醉药品依赖严重影响的患者，肾自体移植可能提供一种保留肾单位的手术解决方案。
