Zaccara A, Pascali M P, Marciano A, Carnevale E, Salvatori G, Dotta A, Nahom A, De Gennaro M
Department of Urology, Bambino Gesu' Children's Hospital, 00165 Rome, Italy.
Adv Urol. 2011;2011:852928. doi: 10.1155/2011/852928. Epub 2011 Jan 5.
VURD syndrome has been repeatedly described as unilateral reflux into a nonfunctioning renal moiety. This syndrome is considered a pop-off mechanism dissipating pressure in lower urinary tract obstruction: it may be found in association with other protective mechanisms occurring in utero, such as ascites and/or urinomas, and has been exclusively described in male patients. A premature female baby with signs and symptoms of outflow obstruction underwent diagnostic workup revealing congenital urethral hypoplasia with unilateral reflux into a dysplastic kidney. Obstetrical history was positive for early onset, serologically negative ascites without cardiomegaly, which required serial aspirations. Reconstructive surgery was carried out with good results: ascites and VURD syndrome were both deemed to be perinatal protective mechanism against excess pressure in the urinary tract. Although rare, lower urinary tract obstruction in the female can lead to the same protective mechanisms seen in male fetuses/newborns. VURD syndrome and ascites should be interpreted as such and require perinatal specialist counselling.
膀胱输尿管反流性发育不良综合征（VURD综合征）一直被反复描述为尿液单侧反流至无功能的肾部分。该综合征被认为是一种在膀胱下尿路梗阻时释放压力的“安全阀”机制：它可能与子宫内出现的其他保护机制有关，如腹水和/或尿瘤，并且仅在男性患者中被描述过。一名有尿道梗阻体征和症状的早产女婴接受了诊断检查，结果显示为先天性尿道发育不全，伴有尿液单侧反流至发育不良的肾脏。产科病史显示早期出现血清学阴性腹水且无心脏肥大，需要反复抽吸。进行了重建手术，效果良好：腹水和VURD综合征均被认为是围产期针对尿路压力过高的保护机制。虽然罕见，但女性下尿路梗阻可导致与男性胎儿/新生儿相同的保护机制。VURD综合征和腹水应如此解读，并需要围产期专科咨询。
