Iqbal Showkathali, Raiz Iqbal, Faiz Iqbal
Amala Institute of Medical Sciences, Amala Nagar; Thrissur - 680555, Kerala, India.
Government Medical College, Kozhikode, Kerala, India.
Malays J Med Sci. 2017 Mar;24(2):106-115. doi: 10.21315/mjms2017.24.2.14. Epub 2017 Apr 14.
Bilateral hydroureteronephrosis involves the dilatation of the renal pelvis, calyces and ureter; it develops secondary to urinary tract obstruction and leads to a build-up of back pressure in the urinary tract, and it may lead to impairment of renal function and ultimately culminate in renal failure. Although clinically silent in most cases, it can be diagnosed as an incidental finding during evaluation of an unrelated cause. In a minority of patients, it presents with signs and symptoms. Renal calculus is the most common cause, but there are multiple non-calculus aetiologies, and they depend on age and sex. Pelviureteric junction obstruction, benign prostatic hypertrophy, urethral stricture, neurogenic bladder, retroperitoneal mass and bladder outlet obstruction are some of the frequent causes of hydroureteronephrosis in adults. The incidence of non-calculus hydronephrosis is more common in males than in females. Ultrasonography is the most important baseline investigation in the evaluation of patients with hydronephrosis. Here, we report a rarely seen case of bilateral hydroureteronephrosis associated with a hypertrophied, trabeculated bladder in an adult male cadaver, suspected to be due to a primary bladder neck obstruction, and analyse its various other causes, clinical presentations and outcomes.
双侧肾盂输尿管积水包括肾盂、肾盏和输尿管扩张；它继发于尿路梗阻，导致尿路内压力升高，可能导致肾功能损害并最终发展为肾衰竭。虽然在大多数情况下临床上无明显症状，但在评估无关病因时可能作为偶然发现而被诊断出来。少数患者会出现体征和症状。肾结石是最常见的病因，但还有多种非结石性病因，且它们取决于年龄和性别。肾盂输尿管连接处梗阻、良性前列腺增生、尿道狭窄、神经源性膀胱、腹膜后肿块和膀胱出口梗阻是成人肾盂输尿管积水的一些常见病因。非结石性肾积水的发病率男性高于女性。超声检查是评估肾积水患者最重要的基线检查。在此，我们报告一例成年男性尸体罕见的双侧肾盂输尿管积水合并膀胱肥厚、小梁化病例，怀疑是由于原发性膀胱颈梗阻所致，并分析其各种其他病因、临床表现和结局。
