Borer J G, Bauer S B, Peters C A, Diamond D A, Decter R M, Shapiro E
Department of Urology, Children's Hospital and Harvard Medical School, Boston, MA 02115, USA.
Br J Urol. 1998 Mar;81(3):474-8. doi: 10.1046/j.1464-410x.1998.00546.x.
To document the array of diagnostic modalities, the variety of errant diagnoses and treatments. and the time from initial presentation to ultimate diagnosis in girls with an ectopic single-system ureter draining an ectopic hypoplastic and/or dysplastic kidney.
Between 1990 and 1997, seven females were identified who had an ectopic hypoplastic and/or dysplastic kidney with an ectopically draining ureter, and who were treated at our institutions, either initially or upon referral. The nature and number of all diagnostic evaluations, previous diagnoses and treatments, and the time from presentation to definitive diagnosis were recorded.
All seven females had a classical history of successful toilet training, a normal voiding pattern and continuous urinary incontinence. Typically, a solitary kidney was noted on the initial diagnostic evaluation by ultrasonography and/or intravenous urography. The mean (range) age at initial presentation was 3.2 (2-6) years. Additionally, voiding cysto-urethrography, urodynamics, radionuclide scintigraphy, computed tomography, magnetic resonance imaging and endoscopy were performed. The age at definitive diagnosis was 3-16.5 years and the mean (range) time from initial presentation to diagnosis was 5.7 (1-10) years. Nephroureterectomy was curative and all kidneys were dysplastic.
Continuous urinary incontinence in females with a normal voiding pattern should prompt an evaluation for ureteric ectopia. When the initial evaluation yields the diagnosis of a solitary kidney, clinicians should be aware of the possibility of a hypoplastic and/or dysplastic, often ectopic, contralateral kidney with an ectopically draining ureter. Identification of this entity should allow curative surgical treatment.
记录诊断方法的种类、错误诊断和治疗的多样性，以及异位单系统输尿管引流异位发育不全和/或发育异常肾脏的女孩从首次就诊到最终诊断的时间。
1990年至1997年间，确定了7名女性，她们患有异位发育不全和/或发育异常的肾脏，伴有异位引流的输尿管，并在我们的机构接受了初始治疗或转诊治疗。记录了所有诊断评估的性质和数量、既往诊断和治疗情况，以及从就诊到明确诊断的时间。
所有7名女性都有成功进行如厕训练的典型病史、正常的排尿模式和持续性尿失禁。通常，在初次超声检查和/或静脉肾盂造影诊断评估中发现单肾。初次就诊时的平均（范围）年龄为3.2（2 - 6）岁。此外，还进行了排尿性膀胱尿道造影、尿动力学检查、放射性核素闪烁扫描、计算机断层扫描、磁共振成像和内镜检查。明确诊断时的年龄为3 - 16.5岁，从初次就诊到诊断的平均（范围）时间为5.7（1 - 10）年。肾输尿管切除术是治愈性的，所有肾脏均发育异常。
排尿模式正常的女性持续性尿失禁应促使对输尿管异位进行评估。当初次评估诊断为单肾时，临床医生应意识到对侧存在发育不全和/或发育异常、通常为异位的肾脏以及异位引流输尿管的可能性。识别出这种情况应允许进行治愈性手术治疗。
