Ye Wen-Xin, Ren Li-Gang, Chen Li
Department of Urology, Tongde Hospital of Zhejiang Province, Hangzhou 310000, Zhejiang Province, China.
World J Clin Cases. 2022 Feb 6;10(4):1326-1332. doi: 10.12998/wjcc.v10.i4.1326.
In the clinical treatment of diseases related to ureteral duplication, it is very important to make a clear diagnosis before surgery because different types of ureteral duplication correspond to different treatment options. Inverted Y ureteral duplication with ectopic ureters and multiple urinary calculi is clinically rare. This case can help clinicians increase their understanding of this disease and gain some experience in its diagnosis and treatment.
A 36-year-old male who was previously healthy presented to the hospital with lumbar pain. Percussion of the right kidney area showed the patient had pain. Computed tomography scans revealed multiple urinary calculi in the right urinary system. Computed tomography urography revealed a duplicated ureteral malformation with an ectopic ureter. A transurethral ureteroscopic holmium laser lithotripsy was performed successfully. Intraoperative retrograde ureterography was performed, and the ectopic ureter was visible. We informed the family of the intraoperative findings and suggested laparoscopic ectopic ureterectomy for the ectopic ureteral stones. Unfortunately, the family temporarily refused laparoscopic surgery. The patient did not feel any discomfort after one year of follow-up.
Inverted Y ureteral duplication with an ectopic ureter and multiple urinary calculi is rare. Clinicians must be highly vigilant, make a correct diagnosis before surgery, determine the type of ureteral duplication and the distribution of urinary calculi, and then draw up a reasonable treatment plan to avoid unnecessary complications.
在输尿管重复相关疾病的临床治疗中,术前明确诊断非常重要,因为不同类型的输尿管重复对应不同的治疗方案。倒Y形输尿管重复伴异位输尿管及多发尿路结石在临床上较为罕见。该病例有助于临床医生增加对这种疾病的认识,并在其诊断和治疗方面积累一些经验。
一名36岁既往健康的男性因腰痛入院。右肾区叩击痛阳性。计算机断层扫描显示右泌尿系统多发尿路结石。计算机断层扫描尿路造影显示输尿管重复畸形伴异位输尿管。成功进行了经尿道输尿管镜钬激光碎石术。术中进行了逆行输尿管造影,可见异位输尿管。我们将术中发现告知了家属,并建议对异位输尿管结石行腹腔镜异位输尿管切除术。不幸的是,家属暂时拒绝了腹腔镜手术。随访一年,患者无任何不适。
倒Y形输尿管重复伴异位输尿管及多发尿路结石较为罕见。临床医生必须高度警惕,术前做出正确诊断,确定输尿管重复的类型及尿路结石的分布,然后制定合理的治疗方案,以避免不必要的并发症。