Pagano P, Passerini G
Br J Urol. 1977 Nov;49(6):469-75. doi: 10.1111/j.1464-410x.1977.tb04185.x.
The clinical presentation and management of 57 primary obstructed megaureters in 46 patients, 35 of whom were children, are reported. Indications for operation include pain, infection, progressive pyelo-ureteric dilatation and reduction in the glomerular filtration rate. We have found that affected children cannot be managed successfully without operation. Conservative treatment may be employed effectively in adults in whom the condition is often stable and complications are less frequent. The preferred surgical technique is ureteric narrowing with reimplantation to the bladder by the Politano-Leadbetter method. The results of surgery are less satisfactory in adults than in children. This may be related to the reduced quantity of elastic tissue in the ureteric wall in adult cases.
报告了46例患者中57条原发性梗阻性巨输尿管的临床表现及治疗情况，其中35例为儿童。手术指征包括疼痛、感染、肾盂输尿管进行性扩张以及肾小球滤过率降低。我们发现，患病儿童若不手术则无法成功治疗。保守治疗对病情通常稳定且并发症较少的成人患者有效。首选的手术技术是采用波利塔诺-利德贝特法将输尿管缩窄并重新植入膀胱。手术结果在成人中不如在儿童中令人满意。这可能与成人病例中输尿管壁弹性组织数量减少有关。
