Satoji Yo, Tobu Shohei, Udo Kazuma, Noguchi Mitsuru
Department of Urology, Faculty of Medicine, Saga University, Saga, Japan.
J Endourol Case Rep. 2020 Dec 29;6(4):283-286. doi: 10.1089/cren.2020.0003. eCollection 2020.
Ureteroceles containing stones present as a unique challenge to the urologist. When a calculus has to be removed from within the ureterocele, a large opening leads to vesicoureteral reflux (VUR), which may result in recurrent infections and renal parenchymal damage. We present a case of a 13-mm stone in the ureterocele in an 11-year-old boy. He was asymptomatic but presented with abnormal urinalysis results and unilateral hydronephrosis. To avoid VUR, we performed minimally invasive transvesical laparoscopic ureterolithotomy, which included partially suturing the incision at the roof of the ureterocele so that a small opening is maintained for drainage of urine. The surgery was performed with no complications and with normal postoperative urinalysis results. The patient's hydronephrosis resolved, and postoperative voiding cystourethrography showed no VUR. Transvesical laparoscopic ureterolithotomy with partial suturing of the incision at the roof of the ureterocele is a good treatment option, particularly for asymptomatic patients.
含有结石的输尿管囊肿给泌尿外科医生带来了独特的挑战。当必须从输尿管囊肿内取出结石时,较大的开口会导致膀胱输尿管反流(VUR),这可能会导致反复感染和肾实质损害。我们报告一例11岁男孩输尿管囊肿内有一枚13毫米结石的病例。他没有症状,但尿常规检查结果异常且有单侧肾积水。为避免VUR,我们进行了微创经膀胱腹腔镜输尿管取石术,其中包括部分缝合输尿管囊肿顶部的切口,以便保留一个小开口用于尿液引流。手术过程无并发症,术后尿常规检查结果正常。患者的肾积水得到缓解,术后排尿性膀胱尿道造影显示无VUR。经膀胱腹腔镜输尿管取石术并部分缝合输尿管囊肿顶部的切口是一种很好的治疗选择,尤其适用于无症状患者。