Ozawa H, Kumon H, Ichikawa T, Nagai A, Ohmori H
Department of Urology, Okayama University Medical School, Shikata, Japan.
Int J Urol. 1998 Jan;5(1):103-5. doi: 10.1111/j.1442-2042.1998.tb00252.x.
Massive bilateral vesicoureteral reflux (VUR) in a 7-year-old girl with spinal scoliosis was successfully treated by endoscopic correction. She was admitted due to a febrile urinary tract infection and urinary incontinence. A cystometrogram demonstrated normal detrusor function during storage. The endoscopic subureteric injection of polytetrafluoroethylene (Teflon) was performed, resulting in the disappearance of the VUR. A postoperative cystometrogram demonstrated overactive detrusor function during storage, necessitating anticholinergic medication. She has been free of febrile urinary tract infections and incontinence for 2 years postoperatively, although self-catheterization is necessary. In a case of neurogenic vesical dysfunction with massive reflux, endoscopic subureteric injection is not only a therapeutic tool, but also a useful diagnostic option for detecting occult detrusor overactivity during storage prior to open surgery.
一名患有脊柱侧弯的7岁女孩的双侧重度膀胱输尿管反流（VUR）通过内镜矫正得到成功治疗。她因发热性尿路感染和尿失禁入院。膀胱测压显示储尿期逼尿肌功能正常。进行了内镜下输尿管下注射聚四氟乙烯（特氟龙），导致VUR消失。术后膀胱测压显示储尿期逼尿肌功能亢进，需要使用抗胆碱能药物。术后2年她未再出现发热性尿路感染和尿失禁，尽管仍需要自行导尿。对于伴有大量反流的神经源性膀胱功能障碍病例，内镜下输尿管下注射不仅是一种治疗手段，也是在开放手术前检测储尿期隐匿性逼尿肌过度活动的有用诊断方法。
