Adams M C, Brock J W, Pope J C, Rink R C
Vanderbilt University Children's Hospital, Nashville, Tennessee, USA.
J Urol. 1998 Sep;160(3 Pt 1):851-3. doi: 10.1016/S0022-5347(01)62819-2.
The conventional technique for ureterocystoplasty includes complete mobilization and incision of the ureter. We describe a modified procedure in which the distal 3 cm. of ureter are left in place and intact.
This modification has been used in our last 13 cases of ureterocystoplasty. The first 7 patients with followup of more than a year (mean 28 months) are included in this series, and 6 have undergone video urodynamic evaluation before and after reconstruction.
Clinical results have been good. Four patients who have been toilet trained are continent. There have been no problems from stagnant urine in the intact ureter with only 1 case of pyelonephritis and no bladder calculi. Mean bladder capacity on cystometrogram has increased from 103 to 236 ml. after reconstruction and reached 137% of expected capacity for age and size (range 110 to 155%). No uninhibited contractions or problems with compliance have been noted.
The distal ureter may be left intact for ureterocystoplasty to protect ureteral blood supply. This modified technique is sound from a physiological standpoint, technically easier and associated with good results.
传统的输尿管膀胱扩大成形术包括输尿管的完全游离和切开。我们描述了一种改良手术方法，即保留输尿管远端3厘米完整。
这种改良方法已应用于我们最近的13例输尿管膀胱扩大成形术中。本系列纳入了前7例随访超过一年（平均28个月）的患者，其中6例在重建前后接受了影像尿动力学评估。
临床效果良好。4例已接受排尿训练的患者能自主控制排尿。完整的输尿管内未出现尿液潴留问题，仅1例肾盂肾炎，无膀胱结石。膀胱测压图显示，重建后平均膀胱容量从103毫升增加到236毫升，达到年龄和体型预期容量的137%（范围为110%至155%）。未发现无抑制性收缩或顺应性问题。
输尿管膀胱扩大成形术可保留输尿管远端完整以保护输尿管血供。这种改良技术从生理学角度来看是合理的，技术上更简便，且效果良好。
