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泌尿生殖系统胚胎学;泌尿妇科医师实用概述。

Embryology of the urogenital tract; a practical overview for urogynecologic surgeons.

机构信息

TriHealth, Division of FPMRS, 9489 Chardon Cir, Apt 111, West Chest, OH, 45069, USA.

出版信息

Int Urogynecol J. 2021 Feb;32(2):239-247. doi: 10.1007/s00192-020-04587-9. Epub 2020 Oct 29.

Abstract

INTRODUCTION AND HYPOTHESIS

Urinary tract anomalies are one of the most common birth defects. Nevertheless, they prove challenging to diagnose as a result of variable presenting symptoms. We aimed to perform a review of urogenital tract development, highlight common congenital upper urinary tract anomalies encountered by urogynecologists and tools to facilitate diagnosis.

METHODS

Multiple searches were performed utilizing resources such as PubMed and the TriHealth library database to access publications related to embryology of the urinary tract and urinary tract anomalies. Each citation was reviewed.

RESULTS

Congenital urinary tract anomalies account for up to 20% of all birth defects and occur more often in females. The true incidence of these malformations is unknown as some can remain clinically insignificant throughout life. In addition, patients may present with non-specific complaints such as urinary tract infections, nephrolithiasis or urinary incontinence. Therefore, unsuspected anomalies pose a risk of delayed diagnosis and potential injury during urogynecologic surgery. Imaging modalities such as computed tomography or magnetic resonance imaging are the most common diagnostic tests. Management and treatment options range from observation to surgical resection with the goal of optimizing long-term functionality and prevention of chronic sequelae.

CONCLUSION

Patients with urinary tract anomalies can present with vague complaints often encountered by urogynecologists. It is crucial to understand the embryologic development of urinary tract anomalies to help facilitate diagnosis and guide care within the office and operating room setting.

摘要

引言和假设

尿路异常是最常见的出生缺陷之一。然而,由于其表现症状多样,因此诊断具有挑战性。我们旨在对泌尿生殖系统的发育进行综述,强调泌尿科医生遇到的常见先天性上尿路异常以及有助于诊断的工具。

方法

利用 PubMed 和 TriHealth 图书馆数据库等资源进行了多次搜索,以获取与尿路胚胎发生和尿路异常相关的出版物。对每个引用进行了审查。

结果

先天性尿路异常占所有出生缺陷的 20% 左右,在女性中更为常见。由于一些畸形在整个生命周期中可能保持临床意义不大,因此这些畸形的真实发生率尚不清楚。此外,患者可能会出现非特异性症状,如尿路感染、肾结石或尿失禁。因此,未被怀疑的异常会导致诊断延迟,并在泌尿妇科手术中存在潜在损伤的风险。最常见的诊断测试是计算机断层扫描或磁共振成像等成像方式。管理和治疗选择范围从观察到手术切除,目标是优化长期功能并预防慢性后遗症。

结论

患有尿路异常的患者可能会出现泌尿科医生经常遇到的模糊症状。了解尿路异常的胚胎发生对于帮助诊断并指导办公室和手术室环境中的护理非常重要。

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