Nezhat Ceana, Rottenberg Howard
Atlanta Center for Minimally Invasive Surgery and Reproductive Medicine, 5555 Peachtree Dunwoody Road, Suite 276, Atlanta, GA 30342, USA.
J Reprod Med. 2009 Jun;54(6):407-10.
The incidence of congenital anomalies of the ureter is very low, as is the incidence of endometriosis of the ureter. The presence of the 2 conditions together is extremely rare. To our knowledge, this is the first description in the medical literature of a laparoscopic ureteroneocystostomy and vesicopsoas hitch in the setting of a double ureter for the treatment of infiltrative endometriosis.
A 31-year-old multigravid woman with a history of severe endometriosis involving the urogenital tract and complete duplication of the right renal collecting system, as well as a right ureterovaginal fistula, presented for evaluation and surgical consult. The patient underwent laparoscopic ureteroneocystostomy and vesicopsoas hitch for the treatment of infiltrative endometriosis with a double ureter.
In skilled operative hands, a minimally invasive approach, applying the principles of laparotomy, in the setting of a duplicated renal collecting system is feasible.
输尿管先天性异常的发生率很低，输尿管子宫内膜异位症的发生率也很低。这两种情况同时存在极为罕见。据我们所知，这是医学文献中首次描述在双输尿管情况下进行腹腔镜输尿管膀胱吻合术和膀胱腰大肌固定术以治疗浸润性子宫内膜异位症。
一名31岁的多产妇女，有严重的涉及泌尿生殖道的子宫内膜异位症病史，右肾集合系统完全重复，以及右输尿管阴道瘘，前来进行评估和手术咨询。该患者接受了腹腔镜输尿管膀胱吻合术和膀胱腰大肌固定术，以治疗伴有双输尿管的浸润性子宫内膜异位症。
在技术熟练者手中，在重复肾集合系统的情况下，应用剖腹手术原则的微创方法是可行的。
