Department of Imaging, University College Hospital London NHS Trust, 235 Euston Road, London NW1 2BU, United Kingdom.
J Pediatr Urol. 2013 Feb;9(1):27-32. doi: 10.1016/j.jpurol.2011.11.003. Epub 2011 Nov 29.
To describe the spectrum and frequency of renal and urological abnormalities in a cohort of patients with uterine anomalies.
We conducted an ethics committee approved review of 164 women referred to the imaging department from a specialist gynaecological anomaly clinic. Imaging acquired over 8 years was assessed and this was sufficient for assessment of the morphology of the gynaecological and renal tracts in 113 patients.
Absent unilateral kidney was the most common abnormality (31.8%), most frequent in Type 3 uterine anomalies. Absent kidneys occurred in other anomaly types at lower frequency. Pelvic ureteric remnants were found in 9 of 36 patients with absent kidneys; these inserted ectopically, most commonly into the vagina. Urological abnormalities were found in 11 patients with two kidneys, including ectopic ureters, scarred kidneys and dysplastic kidney. Obstructed hemivaginas were associated commonly but not invariably with an absent kidney.
Previously unreported renal and urological abnormalities have been described in patients with congenital uterine anomalies. These have significant clinical impact. Ectopic ureters can cause incontinence, and potentially cause pain and become infected. Knowledge of the ureteric course, including ureteric remnants, is essential before complex laparoscopic and vaginal surgery.
描述一组子宫畸形患者的肾脏和泌尿系统异常的谱和频率。
我们对 164 名因妇科异常就诊于影像科的女性进行了一项经伦理委员会批准的回顾性研究。对 8 年来获取的影像学资料进行了评估，其中 113 名患者的影像学资料足以评估妇科和肾脏通道的形态。
单侧肾脏缺如（31.8%）是最常见的异常，在 3 型子宫畸形中最为常见。在其他类型的异常中，肾脏缺如的频率较低。在 36 名单侧肾脏缺如的患者中，有 9 名患者存在盆腔输尿管残迹，这些残迹异位插入，最常见的是插入阴道。在有两个肾脏的 11 名患者中发现了泌尿系统异常，包括异位输尿管、瘢痕肾脏和发育不良肾脏。虽然并不总是如此，但阻塞性半阴道与单侧肾脏缺如有关。
在先天性子宫畸形患者中描述了以前未报道过的肾脏和泌尿系统异常。这些异常具有重要的临床影响。异位输尿管可能导致尿失禁，并可能引起疼痛和感染。在进行复杂的腹腔镜和阴道手术之前，必须了解输尿管的走行，包括输尿管残迹。
