Gleason P E, Kelalis P P, Husmann D A, Kramer S A
Department of Urology, Mayo Clinic, Rochester, Minnesota 55905.
J Urol. 1994 Jun;151(6):1660-1. doi: 10.1016/s0022-5347(17)35338-7.
The incidence, cause and significance of hydronephrosis in patients with renal ectopia are unknown. Therefore, we conducted a retrospective review of 77 patients with 82 ectopic kidneys. Of 82 kidneys 46 (56%) had hydronephrosis. Dilatation of the renal pelvis was the result of primary ureteropelvic or ureterovesical obstruction in 52%, grade 3, 4 or 5 vesicoureteral reflux in 26% and extrarenal collecting systems with malrotation that produced apparent ureteropelvic junction obstruction in 22%. Surgery was performed in 41 patients, including primary nephrectomy in 18, ureteral reimplantation in 14 and ureteropelvic junction repair in 8. Hydronephrosis was present in 15 of 58 contralateral nonectopic kidneys, and 11 required surgery mostly for vesicoureteral reflux. Solitary ectopic kidneys with no associated obstruction or reflux demonstrated normal renal function. Our data indicate that the prognosis in renal ectopia relates directly to the associated urological disease and timely surgical intervention, not to ectopia alone.
肾异位患者肾积水的发病率、病因及意义尚不清楚。因此，我们对77例患者的82个异位肾进行了回顾性研究。82个肾脏中，46个（56%）存在肾积水。肾盂扩张的原因如下：52%为原发性输尿管肾盂或输尿管膀胱梗阻，26%为3级、4级或5级膀胱输尿管反流，22%为肾外集合系统伴旋转不良导致明显的输尿管肾盂连接部梗阻。41例患者接受了手术，其中18例行一期肾切除术，14例行输尿管再植术，8例行输尿管肾盂连接部修复术。58个对侧非异位肾中，15个存在肾积水，其中11个因膀胱输尿管反流大多需要手术治疗。无相关梗阻或反流的孤立异位肾肾功能正常。我们的数据表明，肾异位的预后直接与相关泌尿系统疾病及及时的手术干预有关，而不仅仅与异位本身有关。
