Subihardi Lalu Muhammad Editia, Rahman Ilham Akbar, Yogiswara Niwanda, Rizaldi Fikri
Department of Urology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General-Academic Hospital, Surabaya, East Java, Indonesia.
Department of Urology, Faculty of Medicine, Universitas Airlangga, Universitas Airlangga Teaching Hospital, Surabaya, East Java, Indonesia.
Int J Surg Case Rep. 2023 May;106:108087. doi: 10.1016/j.ijscr.2023.108087. Epub 2023 Mar 31.
Ureterocele is a congenital malformation of the ureter with dilatation in the distal part of the ureter. In most cases, this condition was present in childhood. In cases involving adults, this condition is associated with prolapse as well as the formation of stones. Prolapsed ureterocele with stone is considered to be a very rare case. We report a complex case of prolapsed ureterocele in a young female with a protruding mass in the vagina with complete pyeloureteral duplication and stone in the left ureterovesical junction.
A 19-year-old female presented to the hospital with a complaint of protruding mass in the vagina. A Computed Tomography (CT) scan and Intravenous Urography (IVU) confirmed the presence of a left ureterocele with a complete duplex system and stone in the ureterovesical junction. An endoscopic resection of the ureterocele was performed. One year following surgery, the patient was asymptomatic without deterioration of renal function or urinary tract infection.
Prolapsed ureterocele in adulthood mimicking the clinical appearance of vulvar mass is considered a very rare case. The imaging examination in this case can be identified through CT-Scan. Surgical treatment of ureterocele consisted of incision, multiple punctures, unroofing, or resection. Considering the complex presentation in this case, we decided to undergo endoscopic resection to prevent the incidence of re-prolapsed which later required a second procedure.
In cases of prolapsed ureterocele associated with urethral stones, endoscopic treatment is a viable option for reducing the risk of recurrent ureterocele prolapse.
输尿管囊肿是输尿管的一种先天性畸形，输尿管远端出现扩张。大多数情况下，这种病症在儿童期就已存在。在成人病例中，这种病症与脱垂以及结石形成有关。脱垂性输尿管囊肿合并结石被认为是一种非常罕见的病例。我们报告了一例年轻女性的复杂脱垂性输尿管囊肿病例，该患者阴道内有突出肿物，伴有完全性肾盂输尿管重复畸形以及左输尿管膀胱连接处结石。
一名19岁女性因阴道内突出肿物前来医院就诊。计算机断层扫描（CT）和静脉肾盂造影（IVU）证实存在左侧输尿管囊肿，伴有完全性双肾盂系统以及输尿管膀胱连接处结石。对输尿管囊肿进行了内镜下切除。术后一年，患者无症状，肾功能未恶化，也未发生尿路感染。
成年期脱垂性输尿管囊肿模仿外阴肿物的临床表现被认为是非常罕见的病例。该病例的影像学检查可通过CT扫描来确定。输尿管囊肿的手术治疗包括切开、多次穿刺、去顶或切除。考虑到该病例的复杂表现，我们决定进行内镜下切除以防止再次脱垂的发生，否则后续需要进行二次手术。
在脱垂性输尿管囊肿合并尿道结石的病例中，内镜治疗是降低输尿管囊肿复发脱垂风险的可行选择。
