Advincula Arnold P, Hernandez Jose Carlos
Department of Obstetrics and Gynecology, University of Michigan Medical Center, Ann Arbor 48109, USA.
J Reprod Med. 2006 Mar;51(3):202-4.
Pelvic masses have been known to cause bladder symptoms and compression. This is the first documented case of a large peritoneal inclusion cyst causing acute urinary retention from bladder outlet obstruction.
A 36-year-old woman, gravida 2, para 2, presented to the gynecology clinic with an indwelling Foley catheter that was placed at an outside hospital secondary to acute urinary retention. Computed tomography, performed several days earlier for complaints of progressively worsening lower abdominal and pelvic pain, revealed a 10-cm, complex, cystic mass within the pelvis between the rectum and sigmoid colon, with anterior displacement of the bladder. The patient's past surgical history included a total abdominal hysterectomy as well as separate exploratory laparotomy for resection of a 20-cm peritoneal inclusion cyst and a prophylactic bilateral salpingo-oophorectomy. Due to the acute urinary retention and worsening pain, the decision was made to proceed with laparoscopic removal and drainage of the mass, which turned out to be consistent with a recurrent peritoneal inclusion cyst. Symptom relief was immediate.
A large, recurrent, peritoneal inclusion cyst obstructed the bladder neck and presented as acute urinary retention. Laparoscopy relieved the symptoms.
盆腔肿物已知可引起膀胱症状及压迫。这是首例有文献记载的巨大腹膜包涵囊肿导致膀胱出口梗阻引起急性尿潴留的病例。
一名36岁女性，孕2产2，因急性尿潴留于外院留置Foley导尿管后就诊于妇科门诊。数天前因下腹部及盆腔疼痛进行性加重行计算机断层扫描，显示盆腔内直肠与乙状结肠之间有一个10厘米的复杂囊性肿物，膀胱向前移位。患者既往手术史包括全腹子宫切除术以及分别因切除一个20厘米的腹膜包涵囊肿和预防性双侧输卵管卵巢切除术而行的剖腹探查术。由于急性尿潴留及疼痛加重，决定行腹腔镜下肿物切除及引流术，结果证实为复发性腹膜包涵囊肿。症状立即缓解。
一个巨大的复发性腹膜包涵囊肿阻塞膀胱颈并表现为急性尿潴留。腹腔镜手术缓解了症状。
