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单一异位输尿管。

The single ectopic ureter.

作者信息

Schulman C C

出版信息

Eur Urol. 1976;2(2):64-9. doi: 10.1159/000471964.

Abstract

32 cases of single ectopic ureter have been reviewed. The more remote the ectopic orifice opens from its normal position the more severe were the associated renal anomalies. In the great majority of cases, the corresponding kidney was dysplastic and radiographically functionless. An embryological explanation is proposed to account for the association of single ectopic ureter with a dysplastic kidney. Clinical symptomatology was dribbling incontinence in most female cases and various urogenital complaints in male. An accurate preoperative diagnosis is usually reached with a pyelogram and micturating cystogram. In some female cases a vaginogram or direct puncture and opacification of a vaginal cystic mass may be contributive. In the male, a radiological non-functioning kidney on one side of the urogram associated with a cystic mass palpated above the prostate is pathognomonic of an ectopic ureter opening in the seminal tract. Deferentography may confirm this diagnosis. Treatment of the condition is surgical. In the great majority of cases nephroureterectomy is required. In the male, the abnormal seminal tract involved in this complex malformation should also be removed.

摘要

回顾了32例单侧异位输尿管病例。异位开口距正常位置越远,相关的肾脏异常就越严重。在绝大多数病例中,相应的肾脏发育不良,影像学检查显示无功能。提出了一种胚胎学解释来解释单侧异位输尿管与发育不良肾脏的关联。临床症状在大多数女性病例中为滴沥性尿失禁,在男性中为各种泌尿生殖系统症状。通过肾盂造影和排尿性膀胱造影通常可作出准确的术前诊断。在一些女性病例中,阴道造影或对阴道囊性肿块进行直接穿刺和造影可能会有所帮助。在男性中,尿路造影一侧显示放射性无功能的肾脏,同时在前列腺上方可触及囊性肿块,这是精道内异位输尿管开口的特征性表现。输精管造影可证实这一诊断。该病的治疗方法是手术。在绝大多数病例中,需要进行肾输尿管切除术。在男性中,参与这种复杂畸形的异常精道也应切除。

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