Vijay Mukesh Kumar, Vijay Preeti, Dutta Arindam, Gupta Aman, Tiwari Punit, Kumar Suresh, Bera M K, Das R K, Kundu A K
Institue of Post Graduate Medical Education and Research, Kolkata, India.
Saudi J Kidney Dis Transpl. 2011 Nov;22(6):1169-74.
Endoscopic incision is a good management option for orthotopic ureterocele. But most of the literature has shown its efficacy only in children. We have done this retrospective study to evaluate the safety and efficacy of endoscopic incision of orthotopic ureterocele in adults. From March 2004 to January 2008, at our center, 26 adults underwent transurethral, transverse incision of an ureterocele. The perioperative data of these patients were retrospectively analyzed. The literature was reviewed to identify all the reported options for management of this relatively rare condition in adults. Unilateral ureterocele was present in 24 patients and two patients had bilateral ureterocele. One patient had associated upper tract stones. Three patients had associated stones in ureterocele. Transurethral, transverse incision of ureterocele was given in all patients. The mean postoperative hospital stay was 50.5 h. Twenty-three patients were available for follow-up at three, six and 12 months. All patients were symptom free. At three months ultrasound and intravenous urography revealed no residual ureterocele but four patients showed residual hydronephrosis, but with a decrease in the grade indicating decompression. Micturating cystourethrography revealed vesico-ureteral reflux (VUR) in two patients and the reflux persisted in one patient even at 6 months. We conclude that in adults, management with endoscopic incision of orthotopic ureterocele is safe and effective. VUR may occur in a few cases.
内镜下切开术是治疗原位输尿管囊肿的一种良好治疗选择。但大多数文献仅显示了其在儿童中的疗效。我们进行了这项回顾性研究，以评估成人原位输尿管囊肿内镜下切开术的安全性和有效性。2004年3月至2008年1月，在我们中心，26例成人接受了经尿道输尿管囊肿横向切开术。对这些患者的围手术期数据进行了回顾性分析。查阅文献以确定所有已报道的针对成人这种相对罕见疾病的治疗选择。24例患者为单侧输尿管囊肿，2例患者为双侧输尿管囊肿。1例患者伴有上尿路结石。3例患者输尿管囊肿内伴有结石。所有患者均接受了经尿道输尿管囊肿横向切开术。术后平均住院时间为50.5小时。23例患者在3个月、6个月和12个月时接受了随访。所有患者均无症状。3个月时超声和静脉肾盂造影显示无残留输尿管囊肿，但4例患者显示有残留肾积水，但积水程度减轻，提示有减压。排尿性膀胱尿道造影显示有两名患者存在膀胱输尿管反流（VUR），其中一名患者在6个月时反流仍持续存在。我们得出结论，在成人中，原位输尿管囊肿内镜下切开术的治疗是安全有效的。少数情况下可能会发生VUR。
