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[双侧多发性输尿管息肉致间歇性肾积水:一例报告]

[Bilateral multiple ureteral polyps causing intermittent hydronephrosis: a case report].

作者信息

Oshinomi Kazuhiko, Tsujii Toshihiko, Nanpou Yoshihito, Saneshige Manabu, Satoh Hiroyuki, Asanuma Hiroshi, Shishido Seiichirou

机构信息

Department of Urology, Tokyo Metropolitan, Otsuka Hospital.

出版信息

Nihon Hinyokika Gakkai Zasshi. 2008 Jan;99(1):43-7. doi: 10.5980/jpnjurol1989.99.43.

Abstract

We report an unusual case of bilateral ureteral polyps causing intermittent hydronephrosis, which developed extensively in the upper part of ureters. The patient was an 8-year-old male. He had several episodes of gross hematuria with right flank pain. Ultrasonography of the kidney showed mild bilateral hydronephrosis, while this finding was markedly aggravated in association with the onset of pain. Intravenous pyelogram and retrograde pyelogram revealed multiple filling defects in both upper parts of ureters. Since the diseased part of the ureter was wide (about 7 cm in length), a segmental resection of the right ureter with mobilization of the right kidney was performed, followed by end-to-end ureteral anastomosis. The pathological diagnosis was fibroepithelial polyps. Regarding the disease of contralateral ureter, no surgical treatment was performed because he had no clinical symptoms. Six years after the surgery, he again developed gross hematuria with left flank pain. Marked dilatation of the left renal pelvis was shown by ultrasonography, which suggested left intermittent hydronephrosis caused by ureteral polyps. He underwent a partial ureterectomy with mobilization of the left kidney for the left ureteral disease. No recurrence of polyps has been observed in the urinary tract since this surgery.

摘要

我们报告一例罕见的双侧输尿管息肉导致间歇性肾积水的病例,息肉在输尿管上段广泛生长。患者为一名8岁男性。他有几次肉眼血尿伴右侧腰痛发作。肾脏超声显示双侧轻度肾积水,而这一表现与疼痛发作相关时明显加重。静脉肾盂造影和逆行肾盂造影显示双侧输尿管上段有多个充盈缺损。由于输尿管病变部位较宽(约7厘米长),遂行右侧输尿管节段性切除并游离右肾,随后进行输尿管端端吻合术。病理诊断为纤维上皮性息肉。对于对侧输尿管疾病,因其无临床症状未进行手术治疗。手术后六年,他再次出现肉眼血尿伴左侧腰痛。超声显示左肾盂明显扩张,提示输尿管息肉导致左间歇性肾积水。他因左侧输尿管疾病接受了左肾部分输尿管切除术及左肾游离术。自此次手术后,尿路未见息肉复发。

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