Miyagi Ai, Inaguma Yusuke, Tokoyoda Tomoaki, Nakajima Takashi, Sezaki Ryozo, Matsukawa Tetsuya
Department of Nephrology, Nagoya Ekisaikai Hospital, 4-66 Shonencho, Nakagawaku, Nagoya City, Aichi Prefecture, Japan.
Department of Obstetrics and Gynecology, Nagoya Ekisaikai Hospital, 4-66 Shonencho, Nakagawaku, Nagoya City, Aichi Prefecture, Japan.
CEN Case Rep. 2017 Nov;6(2):125-128. doi: 10.1007/s13730-017-0257-2. Epub 2017 Jun 20.
Pelvic organ prolapse (POP) is the descent of pelvic organs through the vagina, and sometimes causes hydronephrosis. Although the association between POP and hydronephrosis has long been recognized, severe hydronephrosis and renal dysfunction are rarely seen. We report a case of 66-year-old woman who had a vaginal delivery presented with externalized uterine and bladder prolapse during the previous 2 years. She had a 3-day history of hypophagia and vomiting, and laboratory analysis resulted in serum creatinine of 5.75 mg/dL and blood urea of 78.1 mg/dL. The patient was treated urgently with vaginal pessary to return the uterine and bladder into the pelvis. After 2 weeks, her serum creatinine dropped to 3.66 mg/dL, but chronic renal failure persisted. Hydronephrosis caused by POP may lead to renal dysfunction and can advance to irreversible renal damage if left untreated. Important is early evaluation of renal function and images of the kidney and ureter.
盆腔器官脱垂(POP)是指盆腔器官经阴道下移,有时会导致肾积水。尽管POP与肾积水之间的关联早已为人所知,但严重肾积水和肾功能障碍却很少见。我们报告一例66岁经阴道分娩的女性病例,在过去两年中出现子宫和膀胱脱垂至体外。她有3天的食欲不振和呕吐史,实验室检查结果显示血清肌酐为5.75mg/dL,血尿素为78.1mg/dL。该患者紧急接受阴道子宫托治疗,将子宫和膀胱回纳至盆腔。2周后,她的血清肌酐降至3.66mg/dL,但慢性肾衰竭仍持续存在。POP引起的肾积水可能导致肾功能障碍,若不治疗可进展为不可逆的肾损害。重要的是早期评估肾功能以及肾脏和输尿管的影像。