Urology Department, State Pediatric Medical University, 2 Litovskaya Street, build.2, St. Petersburg, Russian Federation, 194100.
BMC Urol. 2020 May 13;20(1):54. doi: 10.1186/s12894-020-00625-2.
Kidney triplication is a rare urological abnormality. Association of triplex kidney and ureterocele is out of ordinary. Treatment of such patients usually implies heminephrureterectomy of the upper moiety. We report a case of a saved function of the upper moiety after minimal invasive surgical procedure.
5-year old girl complained for continuous wetting. Examination revealed 3 - segmented left kidney with pelvi-ureteric dilation of the upper moiety, IV grade vesicoureteral reflux in the upper moiety, cervical ectopic ureteral orifice of the upper moiety and a commune ureteral orifice of the lower segments. An endoscopic laser dissection of ureterocele was performed. Drainage of the upper moiety of triplex kidney was restored. Examination 18 months later showed no wetting and infection symptoms. Pelvi-ureteric dilation of the upper moiety and cavity of ureterocele decreased to minimal. Grade of vesicoureteral reflux decreased to I.
Minimal invasive elimination of obstruction of the upper moiety of triplex kidney was successful and led to regress of vesicoureteral reflux, urinary incontinence and let to avoid heminephrectomy.
肾脏三部分是一种罕见的泌尿科异常。三部分肾脏与输尿管囊肿的关联并不常见。此类患者的治疗通常意味着切除上半部分的半肾输尿管。我们报告了一例微创手术后上半部分功能保留的病例。
一名 5 岁女孩因持续遗尿而就诊。检查发现左肾 3 部分，上半部分肾盂输尿管扩张，上半部分 IV 级膀胱输尿管反流，上半部分颈异位输尿管口和下半部分共同输尿管口。进行了输尿管囊肿的内镜激光切开术。恢复了三部分肾脏上半部分的引流。18 个月后的检查显示没有遗尿和感染症状。上半部分肾盂输尿管扩张和输尿管囊肿腔减小至最小。膀胱输尿管反流分级降低至 I 级。
微创消除三部分肾脏上半部分的梗阻取得了成功，并导致膀胱输尿管反流、尿失禁消退，避免了半肾切除术。
