Division of Urology, Department of Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Curr Urol Rep. 2023 Dec;24(12):591-600. doi: 10.1007/s11934-023-01190-5. Epub 2023 Nov 9.
In this study, we describe a rare case of a male with a duplex renal collecting system with ectopic ureter insertion into the prostate who presented with sepsis and required urgent laparoscopic radical nephrectomy. This study offers urologists and emergency care practitioners a great overview of the variety of manifestations, anatomic differences, and therapeutic approaches for similar patients.
modified reconstructive strategy could be a method of choice when addressing particular anatomies, such as incomplete duplex kidneys with ureteropelvic junction obstruction in both upper and lower poles when the obstruction is close to the confluence of the two ureters. There is a spectrum of acute presentations and management strategies in adult patients with duplex collecting systems. The majority of patients presenting with obstruction and infection are managed surgically with hemi-nephrectomy; stable patients who present with less extensive anomalies were managed conservatively or with ureteral dilatation or deroofing.
本研究描述了一例男性双肾盂收集系统伴异位输尿管插入前列腺的罕见病例，该患者因脓毒症需要紧急腹腔镜根治性肾切除术。本研究为泌尿科医生和急救护理医生提供了一个很好的概述，了解类似患者的各种表现、解剖差异和治疗方法。
当处理特定解剖结构时，改良的重建策略可能是一种选择，例如上、下极均存在肾盂输尿管连接部梗阻的不完全双肾盂，并且梗阻接近两条输尿管汇合处时。成人双肾盂集合系统的急性表现和处理策略存在一定的范围。大多数因梗阻和感染而就诊的患者需要通过半肾切除术进行手术治疗；对于表现出较小范围异常且病情稳定的患者，可采用保守治疗或输尿管扩张或去顶术进行治疗。
