Kleppe Stefanie, Schmitt Joachim, Geipel Annegret, Gembruch Ullrich, Hansmann Manfred, Bartmann Peter, Franke Ingo, Heep Axel
Department of Neonatology, University of Bonn, Bonn, Germany.
J Perinat Med. 2006;34(5):425-8. doi: 10.1515/JPM.2006.085.
Posterior urethral valves (PUV) are a common cause of lower urinary tract obstruction. Renal failure occurs in approximately one third of the cases. It is debated whether urinoma formation is a protective mechanism to reduce pressure-related impairment of renal function. The aim of our study was to determine if urinoma formation is able to preserve renal function on the side of the urinoma.
Five male patients diagnosed with posterior urethral valves and uni- or bilateral urinoma formation were reviewed. Renal function was assessed by serum creatinine level at days 4-7 and at two months, in addition to dimercaptosuccinylacid (DMSA) scintigraphy at 4-6 weeks postnatal age.
Impaired renal function occurred unilaterally in four patients, two had bilateral urinoma formation, and the other two boys presented with unilateral urinoma, one with preserved renal function ipsilateral to the urinoma and the other on the contralateral side. Urinary ascites was detected in three patients, all underwent antenatal centesis.
No association was found between renal function and urinoma formation in patients with PUV.
后尿道瓣膜(PUV)是下尿路梗阻的常见原因。约三分之一的病例会发生肾衰竭。关于尿瘤形成是否是一种减轻与压力相关的肾功能损害的保护机制,目前仍存在争议。我们研究的目的是确定尿瘤形成是否能够保护尿瘤侧的肾功能。
回顾了5例诊断为后尿道瓣膜并伴有单侧或双侧尿瘤形成的男性患者。通过第4 - 7天和两个月时的血清肌酐水平评估肾功能,此外还在出生后4 - 6周进行二巯基丁二酸(DMSA)闪烁扫描。
4例患者出现单侧肾功能受损,2例有双侧尿瘤形成,另外2例男孩有单侧尿瘤,其中1例尿瘤同侧肾功能正常,另1例是对侧肾功能正常。3例患者检测到尿性腹水,均接受了产前穿刺。
后尿道瓣膜患者的肾功能与尿瘤形成之间未发现关联。