Deen Shameer, Ogbu Emmanuel, Walker Nicholas Faure, Nkwam Nkwam Michael
Department of Urology, Princess Royal University Hospital, King's College Hospital NHS Foundation Trust, Farnborough Common, Orpington BR6 8ND, UK.
JRSM Open. 2022 Mar 9;13(3):20542704221077556. doi: 10.1177/20542704221077556. eCollection 2022 Mar.
Spontaneous ureteric rupture is a rare phenomenon which can be traumatic or non-traumatic that may arise from ureteric obstruction, trauma, mucosal inflammation from urolithiasis, connective tissue disease or retroperitoneal fibrosis. High pressure chronic retention is characterised by noctural enuresis, a tense palpable bladder, hypertension, progressive renal impairment, bilateral hydronephrosis and hydroureter on imaging. Obstructive urological symptoms are typically absent in uncomplicated cases. We report the case of a 69-year-old male who presented with high pressure chronic retention and spontaneous ureteric rupture demonstrated on a noncontrast CT. This patient was managed with a urethral catheter on free drainage and a retrograde ureteric stent. The patient's condition improved, and the stent was removed after a uretero-pyeloscopy which revealed no extravasation. He later underwent a successful transurethral resection of the prostate.
自发性输尿管破裂是一种罕见现象,可分为创伤性或非创伤性,可能由输尿管梗阻、创伤、尿路结石引起的黏膜炎症、结缔组织疾病或腹膜后纤维化导致。高压性慢性尿潴留的特征包括夜间遗尿、可触及紧张的膀胱、高血压、进行性肾功能损害、双侧肾积水和输尿管积水(影像学表现)。在无并发症的情况下,通常没有梗阻性泌尿系统症状。我们报告一例69岁男性患者,其因高压性慢性尿潴留就诊,非增强CT显示自发性输尿管破裂。该患者通过留置尿道导管进行自由引流及逆行输尿管支架置入术进行治疗。患者病情改善,输尿管肾盂镜检查显示无外渗后取出支架。他后来成功接受了经尿道前列腺切除术。