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女童先天性尿道息肉:作为阴唇间肿物的鉴别诊断。

Congenital urethral polyps in girls: as a differential diagnosis of interlabial masses.

作者信息

Akbarzadeh Aram, Khorramirouz Reza, Saadat Seyedehpariya, Hiradfar Mehran, Kajbafzadeh Abdol-Mohammad

机构信息

Pediatric Urology Research Center, Pediatric Center of Excellence, Department of Pediatric Urology, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

Department of Pediatric Surgery, Pediatrics, Dr. Sheikh Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

J Pediatr Adolesc Gynecol. 2014 Dec;27(6):330-4. doi: 10.1016/j.jpag.2014.01.001. Epub 2014 Sep 23.

DOI:10.1016/j.jpag.2014.01.001
PMID:25256883
Abstract

STUDY OBJECTIVE

To present the clinical appearance, differential diagnosis, long-term follow-up, and the surgical result of single-center experience with female urethral polyps presenting as an interlabial mass, and to report the common causes of interlabial masses in infants.

DESIGN

All 12 girls who presented with an interlabial mass and intermittent bleeding have been included in this study; however, the benign urethral polyps are discussed in detail and are the subject of this study.

SETTING

All patients were referred to our national referral pediatric urology center with initial impression of vaginal bleeding; however, rhabdomyosarcoma of bladder and urethra (n = 2) or vagina (n = 3) and urethral polyp (n = 7) was the final diagnosis.

PARTICIPANTS

The records of 12 girls who presented with external genitalia bleeding were retrospectively reviewed. Among them, 7 had fibroepithelial polyps and underwent initial polypectomy between 2001 and 2011with mean age of 21.5 months (range: 1-90 mo). All girls underwent endoscopic surgical removal of polyps.

MAIN OUTCOME MEASURES

No postoperative polyp recurrence was observed following endoscopic polyp resection.

RESULTS

The postoperative period was uneventful except in 1 girl who had immediate postoperative urethral bleeding which stopped spontaneously. There was no major complication or polyp recurrence after operation during the long-term follow-up.

CONCLUSIONS

The interlabial mass must be considered as a urethral polyp and should be differentiated from the vaginal rhabdomyosarcoma with protrusion of vaginal tumor from the vaginal outlet or other benign lesions. Physical examination in frog legged position or examination under anesthesia with urethrocystoscopy may confirm the final diagnosis.

摘要

研究目的

介绍以阴唇间肿物形式出现的女性尿道息肉的单中心临床特征、鉴别诊断、长期随访及手术结果,并报告婴儿阴唇间肿物的常见病因。

设计

本研究纳入了所有12例出现阴唇间肿物并伴有间歇性出血的女孩;然而,良性尿道息肉将进行详细讨论,且是本研究的主题。

背景

所有患者最初因阴道出血被转诊至我国的儿科泌尿专科转诊中心;然而,最终诊断为膀胱和尿道横纹肌肉瘤(n = 2)或阴道横纹肌肉瘤(n = 3)以及尿道息肉(n = 7)。

参与者

对12例出现外生殖器出血的女孩的记录进行了回顾性分析。其中7例患有纤维上皮性息肉,并于2001年至2011年间接受了初次息肉切除术,平均年龄为21.5个月(范围:1 - 90个月)。所有女孩均接受了息肉的内镜手术切除。

主要观察指标

内镜下息肉切除术后未观察到息肉复发。

结果

术后过程顺利,仅有1例女孩术后立即出现尿道出血,但出血自行停止。在长期随访期间,术后无重大并发症或息肉复发。

结论

阴唇间肿物必须考虑为尿道息肉,应与阴道横纹肌肉瘤(阴道肿瘤从阴道口突出)或其他良性病变相鉴别。蛙腿位体格检查或在麻醉下进行尿道膀胱镜检查可确诊。

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