Costantini Elisabetta, Lazzeri Massimo, Mearini Luigi, Zucchi Alessandro, Del Zingaro Michele, Porena Massimo
Section of Urology and Andrology, Department of Medical-Surgical Specialties and Public Health, University of Perugia, Perugia, Italy.
Urology. 2009 Feb;73(2):263-7. doi: 10.1016/j.urology.2008.08.480. Epub 2008 Oct 31.
To determine the prevalence of hydronephrosis in a cohort of women who had undergone surgery for pelvic organ prolapse (POP).
This observational, retrospective survey was conducted from January 2000 to December 2007 on 257 consecutive candidates for vaginal or abdominal surgical repair of POP (grade >2). In all patients, a standard clinical and instrumental urogynecologic workup was followed by POP repair. Follow-up visits were scheduled at 3, 6, and 9 months postoperatively and then annually.
Preoperative hydronephrosis was found in 13 patients (5%) with a mean age of 69.2 +/- 6.6 years. It was moderate in 5 and severe in 8; bilateral in 8 (3.1%), monolateral in 5 (1.9%); and POP-related in 9 cases. Surgical POP repair resolved the prolapse all patients and cured the ureterohydronephrosis in 7, with moderate ectasia of the upper urinary tract persisting in 2. The renal function at diagnosis was normal in 12 of 13 patients with hydronephrosis (mean 113 +/- 15 micromol/L); 1 patient had a high serum creatinine concentration (220 micromol/L). No patient developed renal failure during a mean follow-up of 43.5 months.
The prevalence of hydronephrosis was low in patients with POP who were candidates for surgery. POP repair usually resolves prolapse-related hydronephrosis and prevents serious long-term complications.
确定接受盆腔器官脱垂（POP）手术的女性队列中肾积水的患病率。
这项观察性回顾性调查于2000年1月至2007年12月对257例连续的POP（分级>2）阴道或腹部手术修复候选人进行。所有患者在进行标准的临床和器械性泌尿妇科检查后接受POP修复。术后3、6和9个月安排随访，然后每年随访一次。
13例患者（5%）术前发现肾积水，平均年龄69.2±6.6岁。其中5例为中度，8例为重度；双侧8例（3.1%），单侧5例（1.9%）；9例与POP相关。手术修复POP使所有患者的脱垂得到解决，7例治愈输尿管肾积水，2例上尿路中度扩张持续存在。13例肾积水患者中有12例诊断时肾功能正常（平均113±15微摩尔/升）；1例患者血清肌酐浓度高（220微摩尔/升）。在平均43.5个月的随访期间，无患者发生肾衰竭。
拟行手术的POP患者中肾积水患病率较低。POP修复通常可解决与脱垂相关的肾积水并预防严重的长期并发症。
