Viville C, Pezrahid P
Service d'Urologie, Clinique Béthesda, Strasbourg.
Prog Urol. 1991 Dec;1(6):1006-11.
Hydronephrosis secondary to ureteropelvic junction syndrome (UPJ), especially when it is accompanied by moderate dilatation of the proximal renal cavities tends to be stable with little risk to the kidney. However, there are certain exceptions to this general rule and the situation may very suddenly and almost always unpredictably progress towards complete obstruction of the UPJ with loss of function of the corresponding kidney. From a series of about 400 cases of hydronephrosis, 230 of which were operated, the authors analysed 13 cases of intermittent hydronephrosis, three of which suddenly progressed towards complete, irreversible obstruction of the UPJ. This dramatic outcome is difficult to predict, but it would appear to be wise to operate on cases of intermittent hydronephrosis, even when only moderate, especially when they are symptomatic, i.e. Painful. The authors believe that an episode of renal colic without stones constitutes an absolute indication for surgery.
继发于肾盂输尿管连接部综合征(UPJ)的肾积水,尤其是当伴有近端肾盏中度扩张时,往往较为稳定,对肾脏的风险较小。然而,这一普遍规律也有某些例外情况,病情可能会非常突然且几乎总是不可预测地发展为UPJ完全梗阻,导致相应肾脏功能丧失。在一组约400例肾积水病例中,其中230例接受了手术,作者分析了13例间歇性肾积水病例,其中3例突然发展为UPJ完全性、不可逆性梗阻。这种戏剧性的结果很难预测,但对于间歇性肾积水病例,即使程度较轻,尤其是出现症状(即疼痛)时,进行手术似乎是明智的。作者认为,无结石的肾绞痛发作是手术的绝对指征。