Naude J H
Br J Urol. 1984 Dec;56(6):599-601. doi: 10.1111/j.1464-410x.1984.tb06125.x.
A prospective study of apparent obstruction of the ureter by Bilharzia was undertaken. Over a 2-year period, 130 patients with active Bilharzia and 58 patients with inactive or chronic Bilharzia, all of whom had apparently obstructive lesions of the ureter, were studied. Ureteric lesions were examined for true mechanical obstruction by post-micturition erect radiography, erect diuresis renography and, in selected cases, by perfusion pressure flow studies. Of the 130 patients with active Bilharzia, 32 ureters were found to be mechanically obstructed and in each case the obstruction resolved with anti-bilharzial medication. Of the 58 patients with chronic or inactive lesions, only 5 ureters were found to be truly obstructed and required surgery. It is concluded that surgery is unnecessary for ureters obstructed by active Bilharzia within 2 months of starting treatment because the obstruction will resolve in most patients. In the so-called chronic bilharzial stricture, obstruction is more apparent than real and thorough investigation will save many patients from unnecessary surgery.
开展了一项关于血吸虫病导致输尿管明显梗阻的前瞻性研究。在两年时间里，对130例活动性血吸虫病患者和58例非活动性或慢性血吸虫病患者进行了研究，所有患者均有明显的输尿管梗阻性病变。通过排尿后立位X线摄影、立位利尿肾图，并在部分病例中通过灌注压力流量研究，对输尿管病变进行了真正机械性梗阻的检查。在130例活动性血吸虫病患者中，发现32条输尿管存在机械性梗阻，且每例梗阻均通过抗血吸虫药物治疗得以缓解。在58例慢性或非活动性病变患者中，仅发现5条输尿管存在真正的梗阻且需要手术治疗。得出的结论是，在开始治疗后2个月内，对于活动性血吸虫病导致梗阻的输尿管，手术是不必要的，因为大多数患者的梗阻将会缓解。在所谓的慢性血吸虫病狭窄中，梗阻更多是表面现象而非实际情况，进行全面检查可使许多患者避免不必要的手术。
