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膀胱苗勒管残余症:三例新病例报告

Müllerianosis of the urinary bladder: report of three new cases.

作者信息

Casasayas-Carles Paula, Fuentes-Marquez Isabel, Tarrasa-Sagristá Fernando, Gutiérrez Sanz-Gadea Carlos

机构信息

Servicio de Urología. Hospital de Son Llátzer. Palma de Mallorca. Islas Baleares. España.

出版信息

Arch Esp Urol. 2014 Nov;67(9):771-5.

Abstract

OBJECTIVE

We report three new cases of müllerianosis of the urinary bladder.

METHODS

We present three cases of women in the third decade of life, two of them presenting hematuria and pelvic pain, and the third was referred to perform a recto-vaginal endometriosis surgical procedure. Diagnosis was made by ultrasound and cystoscopy in the first and second case, and by CT scan in the endometriosis case.

RESULTS

Müllerianosis of the urinary bladder is described as the presence of müllerian remnants (endometrial, endosalpinx and endocervix) in the bladder wall. Diagnosis is made as a result of a pathologic study of the resected lesions. Although a relapse of the disease is infrequent, it can happen, and close monitoring of the patients must be performed.

CONCLUSIONS

Müllerianosis of the bladder is a rare condition and differential diagnosis must be done with benign and malignant bladder lesions because it can affect the muscularis propia. It mostly presents as lower urinary tract symptoms and hematuria that can be cyclic. Transurethral resection is the treatment of choice in superficial and focal lesions. In the case of infiltration of the bladder muscle, and depending on the extension of the disease, partial cystectomy may be necessary.

摘要

目的

我们报告三例膀胱苗勒管残余症新病例。

方法

我们呈现三例处于三十多岁的女性病例,其中两例表现为血尿和盆腔疼痛,第三例因直肠阴道子宫内膜异位症而被转诊接受手术治疗。第一例和第二例通过超声和膀胱镜检查确诊,子宫内膜异位症病例通过CT扫描确诊。

结果

膀胱苗勒管残余症被描述为膀胱壁中存在苗勒管残余组织(子宫内膜、输卵管内膜和子宫颈内膜)。通过对切除病变的病理研究做出诊断。尽管该疾病复发不常见,但仍可能发生,因此必须对患者进行密切监测。

结论

膀胱苗勒管残余症是一种罕见疾病,必须与膀胱的良性和恶性病变进行鉴别诊断,因为它可能累及固有肌层。其主要表现为下尿路症状和可能呈周期性的血尿。经尿道切除术是浅表性和局灶性病变的首选治疗方法。对于膀胱肌肉浸润的情况,根据疾病的范围,可能需要进行部分膀胱切除术。

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