Taguchi K, Shimada K, Ikoma F
Department of Urology, Hyogo College of Medicine.
Hinyokika Kiyo. 1991 Nov;37(11):1389-94.
Advances and spread in ultrasonography in obstetrics have resulted in the increase in the number of reports of congenital anatomical anomalies that have been diagnosed prenatally. We present 56 patients with congenital urinary tract anomalies, which were found by prenatal USG. These anomalies included pelvi-ureteric junction stenosis in 19, multicystic kidney in 12, primary megaureter in 6, ureterocele in 4, posterior urethral valve in 3, polycystic kidney in 2, vesicoureteral reflux in 2, urogenital sinus anomaly in 2 and others in 4. There were 9 oligohydramnios: posterior urethral valve in 2, polycystic kidney in 2, bilateral multicystic kidney in 2, urogenital sinus anomaly in 2 and vesicoureteral reflux in 1. In the neonatal period, urological treatment was performed on 13 patients; indwelling catheter on 4, vesicostomy on 2, ureterocutaneostomy on 2, TUR cele on 2 and others on 3. Among the cases, 25 have been operated on after the various intervals of follow-up periods. Pyeloplasty was performed on 9 patients with pelvi-ureteric junction stenosis, total reconstriction on 4 with ureterocele, ureterocystoneostomy on 3 with megaureter and others on 9. There were 7 lethal cases; polycystic kidney in 2, multicystic kidney in 2, posterior urethral valve in 1, megaureter in 1 and urogenital sinus anomaly in 1. It seems likely that various kinds and increasing number of urinary tract abnormalities will be diagnosed through prenatal USG. It is now important to make a consensus for the timing and management of the therapy of these anomalies.
产科超声检查技术的进步与普及,使得产前诊断出的先天性解剖异常报告数量有所增加。我们报告了56例产前超声检查发现的先天性泌尿系统异常患者。这些异常包括肾盂输尿管连接处狭窄19例、多囊肾12例、原发性巨输尿管6例、输尿管囊肿4例、后尿道瓣膜3例、多囊肾2例、膀胱输尿管反流2例、泌尿生殖窦异常2例以及其他类型4例。羊水过少9例:后尿道瓣膜2例、多囊肾2例、双侧多囊肾2例、泌尿生殖窦异常2例、膀胱输尿管反流1例。新生儿期,对13例患者进行了泌尿外科治疗;留置导尿管4例、膀胱造瘘术2例、输尿管皮肤造口术2例、经尿道电切囊肿2例、其他手术3例。在这些病例中,25例在不同随访期后接受了手术。9例肾盂输尿管连接处狭窄患者接受了肾盂成形术,4例输尿管囊肿患者接受了全重建术,3例巨输尿管患者接受了输尿管膀胱吻合术,其他9例接受了不同手术。有7例死亡病例;多囊肾2例、多囊肾2例、后尿道瓣膜1例、巨输尿管1例、泌尿生殖窦异常1例。通过产前超声检查似乎有可能诊断出更多种类的泌尿系统异常。现在,就这些异常的治疗时机和管理达成共识很重要。