Encinas Goenechea A, Gómez Fraile A, Aransay Bramtot A, López Vázquez F, Matute de Cárdenas J A
Sección de Urología Pediátrica, Hospital 12 de Octubre, Madrid.
Cir Pediatr. 1995 Jul;8(3):108-12.
From 1981 to 1993, we have treated 31 pediatric patients with ectopic ureterocele (associated to duplex system, intra and extravesicals). Diagnostic work-up included abdominal ultrasound, intravenous urography (IVU), sequence mictional cystouretrography (SM-CU) and diuresis renography (DTPA-DMSA o MAG-3). Patients were divided in two groups: 1. Good renal function in the affected system (5 cases) with 2 endoscopic incision of the ureterocele and 3 without surgical treatment (all intravesical). 2. Almost non-existent ipsilateral renal function (26 cases), treated by heminephrectomy and ureterocelic aspiration, and in the remaining a nephrectomy was done for ipsilateral non-existent renal function. 2 cases treated by endoscopic incision presented vesicoureteral reflux, and 4 cases treated by nephrectomy had a low grade reflux. There is no a definite treatment established. The choice should by made based on renal function. Endoscopic incision is a good choice in obstructed cases with good renal function. In those with no function at all, heminephrectomy with aspiration of the ureterocele will be the best treatment if we consider that almost 50 percent of the patients will need a second surgical procedure.
1981年至1993年期间，我们共治疗了31例患有异位输尿管囊肿（与重复肾系统相关，包括膀胱内和膀胱外）的儿科患者。诊断性检查包括腹部超声、静脉尿路造影（IVU）、连续排尿膀胱尿道造影（SM-CU）和利尿肾图（DTPA-DMSA或MAG-3）。患者被分为两组：1. 患侧系统肾功能良好（5例），其中2例行输尿管囊肿内镜切开术，3例未接受手术治疗（均为膀胱内型）。2. 患侧肾功能几乎不存在（26例），接受半肾切除术和输尿管囊肿抽吸治疗，其余患者因患侧肾功能不存在而进行了肾切除术。2例接受内镜切开术治疗的患者出现膀胱输尿管反流，4例接受肾切除术治疗的患者有轻度反流。目前尚无明确的既定治疗方法。应根据肾功能做出选择。内镜切开术是肾功能良好的梗阻病例的良好选择。对于完全无功能的患者，如果考虑到近50%的患者需要二次手术，半肾切除术加输尿管囊肿抽吸术将是最佳治疗方法。
