Proca E, Sinescu I
Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir. 1989 Jul-Aug;38(4):241-9.
The paper reports on the results of the endoscopic treatment in 16 cases of orthotopic ureterocele, out of which 11 developed on a simplex ureter and 5 on the superior ureter of the pyeloureteral duplicity (ren duplex). In 6 patients the pseudocystic dilatation of the submucous ureter contained calculi. The endoscopic treatment consisted of: the ureterocele resection in 12 patients (in 6 of them it was associated with the extraction of the calculi with Lowsley's lithotryptic clip): the ureterocele incision in 3 cases; and the endoscopic resection of the intravesical sac, with nephrouretectomy of the dysfunctional pelvis and the respective ureter in one case. The results recorded showed urographic improvement in 14 patients and uroculture sterilization in 11 cases of 14 with postsurgical urinary infections. Only in one case, the ureterohydronephrosis advanced, requiring the subsequent ureter-bladder reimplantation. No case of bladder-ureter reflux following the endoscopic resection or incision of the orthotopic ureterocele was recorded. Endoscopic resection or incision is a simple and efficient method for treating small or middle orthotopic ureteroceles, if the superior urinary system is recoverable. The method is simple and with low risks, and it can be applied as first therapeutic time in all the cases, even in those in which the chance of the definitive solution is less probable, as in the secondary surgical time the classical surgical correction of the uretero-bladder junction can be used.
本文报道了16例原位输尿管囊肿的内镜治疗结果，其中11例发生于单纯输尿管，5例发生于肾盂输尿管重复畸形（重复肾）的上输尿管。6例患者黏膜下输尿管的假性囊肿扩张内含有结石。内镜治疗包括：12例患者行输尿管囊肿切除术（其中6例联合使用Lowsley碎石钳取石）；3例行输尿管囊肿切开术；1例行膀胱内囊肿内镜切除术，同时对功能异常的肾盂及相应输尿管行肾输尿管切除术。记录结果显示，14例患者尿路造影改善，14例术后发生尿路感染的患者中有11例尿培养转阴。仅1例患者输尿管肾积水进展，随后需要行输尿管膀胱再植术。原位输尿管囊肿内镜切除或切开术后未记录到膀胱输尿管反流病例。如果上尿路系统可恢复，内镜切除或切开是治疗中小型原位输尿管囊肿的一种简单有效的方法。该方法简单且风险低，可作为所有病例的首选治疗方法，即使在确定性解决方案可能性较小的情况下也是如此，因为在二次手术时可采用经典的输尿管膀胱连接部手术矫正方法。
