Urology Department, Charles Nicolle Hospital, Tunis, Tunisia.
Pan Afr Med J. 2020 Aug 4;36:243. doi: 10.11604/pamj.2020.36.243.24941. eCollection 2020.
To evaluate the efficacy of endoscopic meatotomy in the treatment of ureterocele in adults. A retrospective study of adult patients with ureterocele, treated between January 1987 and December 2014. In 47 patients, 55 intravesical ureteroceles were diagnosed and classified as 18 right, 21 left and eight bilateral (38%, 44% and 17% respectively). According to the Bruézière classification, 41 (75%) ureteroceles were type A and 14 (25%) others were type C. These ureteroceles were complicated by calculus formation in 22 cases, moderately dilated excretory pathways in 16 cases and both complications in a total of 9 cases. Four patients had a complicated ureterocele with pyelonephritis, one of which was emphysematous. The endoscopic treatment was performed in cases of complicated and/or symptomatic ureteroceles. Fifty one cases were treated by a "smiling mouth" meatotomy consisting in a transverse horizontal incision, with the treatment of any associated complication. The mean operative time was 35 minutes (10-90). The operative follow-up was uneventful in 42 patients and complications occurred in 5 patients (2 urinary retentions, 2 infectious complications and one hematuria). The mean duration of postoperative stay was 1-2 days. The mean follow-up was 15 months. Four patients developed vesicoureteral reflux and no stenosis was noted. The endoscopic incision of the ureteroceles seems today, after reviewing the results, to be a good treatment of adult ureterocele. It is a simple, minimally invasive and has a low morbidity rate.
评估内镜下经口切开术治疗成人输尿管口囊肿的疗效。回顾性分析 1987 年 1 月至 2014 年 12 月期间接受治疗的成人输尿管口囊肿患者。47 例患者中，55 个膀胱内输尿管口囊肿被诊断并分类为 18 个右侧、21 个左侧和 8 个双侧（分别为 38%、44%和 17%）。根据 Bruézière 分类，41 个（75%）输尿管口囊肿为 A 型，14 个（25%）为 C 型。这些输尿管口囊肿中有 22 例伴有结石形成，16 例伴有排泄通路中度扩张，9 例同时伴有两种并发症。4 例并发输尿管口囊肿伴肾盂肾炎，其中 1 例为气肿性。内镜治疗适用于复杂和/或有症状的输尿管口囊肿。51 例采用“微笑口”经口切开术治疗，包括横行水平切口，同时治疗任何相关并发症。平均手术时间为 35 分钟（10-90 分钟）。42 例患者术后无并发症，5 例患者出现并发症（2 例尿潴留、2 例感染并发症和 1 例血尿）。术后平均住院时间为 1-2 天。平均随访时间为 15 个月。4 例患者发生膀胱输尿管反流，无狭窄。回顾结果显示，内镜下切开输尿管口囊肿术是治疗成人输尿管口囊肿的一种较好方法。该手术简单、微创，发病率低。
