Scherz H C, Kaplan G W, Packer M G, Brock W A
Children's Hospital and Health Center, San Diego, California.
J Urol. 1989 Aug;142(2 Pt 2):538-41; discussion 542-3. doi: 10.1016/s0022-5347(17)38808-0.
During the last 19 years we treated 60 children with ectopic ureteroceles. There was a 4 to 1 female-to-male predominance. Of the patients 47 per cent presented before age 6 months, 66 per cent were diagnosed after a urinary tract infection and 6 were identified antenatally. Based upon a review of the literature and our data, we believe that "total correction" (a single operation designed to correct abnormalities of the upper and lower urinary tract) is superior in most instances to an approach in which just the upper urinary tract pathological condition is treated. Only 4 (14 per cent) of 28 patients in whom "total correction" was used required a second operation (all because of persistent reflux) while 14 of 19 patients (74 per cent) treated with an upper urinary tract procedure intended as definitive therapy have either undergone further surgery or have a residual abnormality that may require further surgery. Marsupialization rather than enucleation of the ectopic ureterocele is effective and safe, risking neither injury to the bladder neck or sphincteric mechanism nor resulting in a vesicovaginal fistula.
在过去19年里，我们治疗了60例患异位输尿管囊肿的儿童。男女比例为4比1，女性居多。47%的患者在6个月龄前就诊，66%的患者在尿路感染后被诊断出来，6例是在产前确诊的。基于文献回顾和我们的数据，我们认为，在大多数情况下，“完全矫正”（旨在矫正上尿路和下尿路异常的单一手术）比仅治疗上尿路病理状况的方法更具优势。采用“完全矫正”的28例患者中，只有4例（14%）需要二次手术（均因持续性反流），而19例接受上尿路手术作为确定性治疗的患者中，有14例（74%）要么接受了进一步手术，要么存在可能需要进一步手术的残余异常。异位输尿管囊肿行袋形缝合术而非摘除术是有效且安全的，既不会损伤膀胱颈或括约肌机制，也不会导致膀胱阴道瘘。
