子宫脱垂手术矫正后部分重复集合系统的双侧输尿管梗阻情况改善：一例报告
Bilateral ureteric obstruction of a partially duplicated collecting system improves after surgical correction of procidentia: a case report.
作者信息
White Amanda B, Wai Clifford Y, Marinis Spyridon I, Schaffer Joseph I
机构信息
Division of Urogynecology/Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9032, USA.
出版信息
J Reprod Med. 2008 Jun;53(6):449-52.
BACKGROUND
Although the association between pelvic organ prolapse and upper urinary tract dilation has been documented, the causal relationship between the two has not been established. We report an improvement in severe hydronephrosis and hydroureter of a partially duplicated urinary collecting system after surgical correction of procidentia.
CASE
A 52-year-old woman presented with radiologic evidence of a partially duplicated right collecting system with right-sided hydronephrosis and bilateral hydroureter in the setting of stage IV uterovaginal prolapse. A therapeutic trial of pessary placement failed to resolve the upper urinary tract dilation. The patient underwent abdominal hysterectomy, bilateral salpingo-oophorectomy, sacrocolpopexy, mid-urethral sling placement and posterior colporrhaphy. Repeat intravenous urography 4 weeks after surgery demonstrated interval resolution of the hydronephrosis.
CONCLUSION
An improvement in hydronephrosis after surgical correction supports a cause-and-effect relationship between pelvic organ prolapse and obstructive uropathy.
背景
虽然盆腔器官脱垂与上尿路扩张之间的关联已有文献记载，但两者之间的因果关系尚未确立。我们报告了一例在子宫脱垂手术矫正后，部分重复的泌尿系统积水性肾积脓和输尿管积水情况得到改善的病例。
病例
一名52岁女性，影像学检查显示右侧泌尿系统部分重复，伴有右侧肾积水及双侧输尿管积水，同时存在IV期子宫阴道脱垂。放置子宫托的治疗试验未能缓解上尿路扩张。患者接受了腹式子宫切除术、双侧输卵管卵巢切除术、骶骨阴道固定术、尿道中段吊带置入术和阴道后壁修补术。术后4周重复静脉肾盂造影显示肾积水逐渐消退。
结论
手术矫正后肾积水情况改善，支持盆腔器官脱垂与梗阻性尿路病之间存在因果关系。
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