Bachor R, Kleinschmidt K, Gottfried H W, Hautmann R
Urologische Universitätsklinik Ulm.
Urologe A. 1997 Jul;36(4):335-8. doi: 10.1007/s001200050107.
For routine evaluation of ureteropelvic junction obstruction in children, sonography, voiding cystogram, IV pyelogram and a renal scan in combination with administration of furosemide are available. Furthermore, often preoperative antegrade or retrograde ureteropyelography is performed. However, the significance of retrograde ureteropyelography in the world literature remains controversial. Therefore, we reviewed the records of 41 children who underwent a pyeloplasty in our department. In 9 children the ureter was visualized by IV pyelogram, voiding cystogram or antegrade ureteropyelography; a retrograde examination of the ureter was performed in 21 children before pyeloplasty in the OR. In 11 children the ureter was not visualized preoperatively. Retrograde ureterography neither gave additional information in any patient nor did it change the operative technique. In the children where the ureter was not visualized preoperatively, no ureteric abnormality was found in association with ureteropelvic junction obstruction. Hence, we conclude that retrograde ureteropyelography before pyeloplasty in children is not necessary, provided that sonography does not show ureteral dilatation.
对于儿童肾盂输尿管连接部梗阻的常规评估，可采用超声检查、排尿性膀胱尿道造影、静脉肾盂造影以及联合应用呋塞米的肾扫描。此外，术前常进行顺行或逆行输尿管肾盂造影。然而，逆行输尿管肾盂造影在世界文献中的意义仍存在争议。因此，我们回顾了在我院接受肾盂成形术的41例儿童的病历。9例儿童通过静脉肾盂造影、排尿性膀胱尿道造影或顺行输尿管肾盂造影使输尿管显影；21例儿童在手术室进行肾盂成形术前接受了输尿管逆行检查。11例儿童术前输尿管未显影。逆行输尿管造影在任何患者中均未提供额外信息，也未改变手术技术。在术前输尿管未显影的儿童中，未发现与肾盂输尿管连接部梗阻相关的输尿管异常。因此，我们得出结论，在儿童肾盂成形术前，如果超声检查未显示输尿管扩张，则无需进行逆行输尿管肾盂造影。
