Huong D L, Papo T, Piette J C, Wechsler B, Bletry O, Richard F, Valcke J C, Godeau P
Department of Internal Medicine, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
Medicine (Baltimore). 1995 May;74(3):152-61. doi: 10.1097/00005792-199505000-00005.
We report 8 patients with Wegener granulomatosis (WG) who suffered from symptomatic urogenital involvement including acute urinary retention related to prostatitis, orchitis, ureteral stenosis, bladder pseudotumor, and penile ulceration. Urogenital manifestations occurred as an isolated manifestation of WG in 4 patients, at the onset of the disease in 1 patient, and as the only symptom of relapse in 3. Data used to distinguish specific WG involvement from infection or cyclophosphamide urothelial toxicity are discussed. Four patients needed a surgical procedure consisting of suprapubic cystostomy for acute urinary retention, bilateral ureteral double J stents for bilateral ureteral stenosis, and prostate transurethral resection. Urogenital symptoms promptly resolved with medical therapy. High-dose corticosteroids and immunosuppressive drugs should be used as first-line therapy to avoid unnecessary surgery.
我们报告了8例韦格纳肉芽肿（WG）患者，他们出现了有症状的泌尿生殖系统受累情况，包括与前列腺炎相关的急性尿潴留、睾丸炎、输尿管狭窄、膀胱假性肿瘤和阴茎溃疡。泌尿生殖系统表现为4例患者的WG孤立表现，1例患者在疾病发作时出现，3例患者作为复发的唯一症状出现。文中讨论了用于区分WG特定受累与感染或环磷酰胺尿路上皮毒性的数据。4例患者需要进行手术，包括因急性尿潴留行耻骨上膀胱造瘘术、因双侧输尿管狭窄行双侧输尿管双J支架置入术以及经尿道前列腺切除术。泌尿生殖系统症状经药物治疗后迅速缓解。应将高剂量皮质类固醇和免疫抑制药物用作一线治疗，以避免不必要的手术。
