Tawfiek E R, Bagley D H
Department of Urology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
J Urol. 1998 Sep;160(3 Pt 1):700-2. doi: 10.1016/S0022-5347(01)62762-9.
Chronic unilateral hematuria constitutes a difficult problem of diagnosis and treatment. We evaluated 23 patients with unilateral renal hematuria to determine the cause of bleeding and to evaluate ureteroscopic treatment.
A total of 23 patients with chronic unilateral hematuria were evaluated ureteroscopically during a 2-year period. Semirigid and flexible ureteroscopes were used to evaluate all patients. Dilation of the ureterovesical junction was required in only 1 patient.
The entire ureter and intrarenal collecting system were inspected in all patients. Discrete lesions comprised hemangioma in 7, minute venous rupture in 3, small papillary tumor in 3 and calculus in 2 patients which were treated successfully. Nonspecific lesions comprised submucosal erythema in 2 patients and abnormal papillary tip in 1 which were treated successfully as well. In the remaining 5 patients no lesions were detected. In all treated patients hematuria resolved with no recurrence during a mean followup of 8 months (range 4 to 18).
Ureteroscopy is an important diagnostic and therapeutic procedure for patients with chronic unilateral hematuria.
慢性单侧血尿构成了诊断和治疗上的难题。我们评估了23例单侧肾血尿患者，以确定出血原因并评估输尿管镜治疗效果。
在2年期间，对23例慢性单侧血尿患者进行了输尿管镜检查。所有患者均使用半硬性和软性输尿管镜进行评估。仅1例患者需要扩张输尿管膀胱连接部。
对所有患者的整个输尿管和肾内集合系统进行了检查。离散性病变包括7例血管瘤、3例微小静脉破裂、3例小乳头状肿瘤和2例结石，均成功治疗。非特异性病变包括2例黏膜下红斑和1例异常乳头尖端，也成功治疗。其余5例患者未发现病变。所有接受治疗的患者血尿均消失，平均随访8个月（4至18个月）无复发。
输尿管镜检查是慢性单侧血尿患者重要的诊断和治疗方法。
