Mandal Soumendra Nath, Jagadheesan Gokulakrishnan Puttuthakku, Kamal Mir Reza, Mukherjee Satyadip, Das Ranjit Kumar, Karmakar Dilip
Department of Urology, Calcutta National Medical College and Hospital, Kolkata, India.
Korean J Urol. 2013 Jul;54(7):482-5. doi: 10.4111/kju.2013.54.7.482. Epub 2013 Jul 15.
A 16-year-old female presented with dribbling of urine along with voluntary voiding since birth. Renal imaging revealed hydroureteronephrosis on the right side; the uterus and ovary were normal. A radionuclide scan showed a left nonfunctional kidney. On cystovaginoscopy, the urethra was shown to be normal and the urinary bladder was tubular with small capacity and an absent trigone. Although the vagina was capacious, no ureteric orifices were found. Computed tomography corroborated the diagnosis of bilateral, single ectopic ureters draining into a grossly dilated vagina. This case is unique because it is a bilateral single-system ureteral ectopia in a completely differentiated female genital tract that presented late in adolescence. To the best of our knowledge, this is the second such ureteral abnormality reported in the literature so far. The patient underwent ileocystoplasty with right ureteric reimplantation and nephroureterectomy for the left nonfunctional kidney, which histopathology showed to be tuberculosis. The patient is continent with cystometric capacity of more than 300 mL.
一名16岁女性自出生以来一直存在尿液滴沥并伴有自主排尿。肾脏影像学检查显示右侧肾盂输尿管积水;子宫和卵巢正常。放射性核素扫描显示左侧肾脏无功能。膀胱阴道镜检查显示尿道正常,膀胱呈管状,容量小且无三角区。尽管阴道宽敞,但未发现输尿管口。计算机断层扫描证实诊断为双侧单系统异位输尿管排入明显扩张的阴道。该病例独特之处在于它是青春期后期出现的完全分化女性生殖道中的双侧单系统输尿管异位。据我们所知,这是迄今为止文献中报道的第二例此类输尿管异常。患者接受了回肠膀胱扩大术并将右侧输尿管重新植入,对左侧无功能肾脏进行了肾输尿管切除术,组织病理学显示为结核病。患者控尿良好,膀胱测压容量超过300毫升。