女性重复肾输尿管及膀胱九例报告  

Female duplication of kidney ureter and bladder：9 cases report

作　　者：邹忠香[1] 黄逢雨[2] 高建美[1] 

机构地区：[1]山东省烟台市莱阳中心医院妇产科,265200 [2]山东省烟台市莱阳中心医院泌尿外科,265200

出　　处：《中华泌尿外科杂志》2010年第5期315-318,共4页Chinese Journal of Urology

摘　　要：目的 总结女性重复肾输尿管及膀胱的诊治体会. 方法女性重复肾输尿管及膀胱患者9例,平均年龄33（26～53）岁.其中重复肾重复输尿管发生在左侧6例、右侧2例、双侧1例.单侧8例重复膀胱为不完全性;双侧重复者1例为完全性重复膀胱,且合并重复尿道、重复子宫及双侧输卵管卵巢,患者重复子宫脱垂Ⅱ度,阴道前壁及重复膀胱膨出.9例均因阴道脱出肿物就诊,经查体、影像学检查并经术中证实诊断8例,1例误诊为阴道壁囊肿者术中确诊.重复肾重度积水无功能者2例行重复肾、重复输尿管全长及重复膀胱切除;重复肾存在分泌功能者7例,行重复膀胱切除、重复输尿管下段膀胱再植术6例;1例完全性重复膀胱合并重复尿道、重复子宫及双侧输卵管卵巢、重复子宫脱垂Ⅱ度、阴道前壁及重复膀胱膨出者行重复膀胱、重复子宫附件及重复尿道切除,重复输尿管下段膀胱再植术. 结果 9例手术均成功,未发生漏尿及输尿管残端综合征.7例输尿管膀胱再植者术后3个月膀胱造影显示输尿管无反流.术后12个月复查IVU,2例重复肾切除者显示患侧残肾形态及功能正常,7例输尿管膀胱再植者显示患侧肾脏及重复肾形态功能良好.合并重复子宫附件者术后1.5年妊娠. 结论影像学检查是诊断重复肾输尿管及膀胱的重要手段.手术是治疗该病的主要方法,术前应重点了解重复肾功能、输尿管形态及走向.手术方式应以解除病痛、保护患肾及重复肾功能、避免感染为原则.Objective To report the experiences on the diagnosis and treatment of duplication of kidney ureter and bladder. Methods Nine cases of duplication of kidney ureter and bladder from 1996 to 2008 were reviewed.Six cases of duplicated kidney ureter occurred in the left side and 2 cases in the right side,1 case bilateral kidney ureteral duplication.Of 8 cases with unilateral duplicated,duplicated bladders were incompleteness.And the patient with bilateral duplicated,whose duplicated bladder was completeness,was diagnosed with duplication of urethra,uterine,bilateral ovary and oviduet tubes,and also suffered from duplicated uterine prolapse Ⅱ,vaginal anterior wall bulging and duplicated vesicocele.There were two cases whose duplicated kidney losed function because of severe hydronephrosis,and 7 cases existed kidney secretion function. Excision of duplicated kidney ureter and bladder were performed on 2 cases with non-functional duplicated kidney.6 cases had undergone duplicated bladder excision and duplicated ureteral bladder replantation.The special case had undergone duplicated urinary bladder urethra uterine and bilateral annexes excision,and duplicated ureteral bladder replantation. Results The operation was successful in all paients without leakage and ureter stump syndrome.Three months after operation,ureter bladder imaging showed no ureteral reflux in 7 cases of ureteral bladder replantation.IVU were reviewed 12 months after operation：2 cases undergoing duplicated kidney excision showed that the function of residual kidney were normal,7 cases of replantation that the shape and function of sick side kidney and duplicated kidney were good. The patient who suffered from duplicated uterine simultaneously got pregnancy 1.5 years after operation. Conclsions Image examinations may help to diagnose the duplication of kidney ureter and bladder. The main treatment is surgery. Understanding the function of duplicated kidney and the shape of kidney ureter and bladder should be considered before operation. The goal of su

关 键 词：女性 泌尿生殖系统畸形 输尿管膀胱再植术 

分 类 号：R699[医药卫生—泌尿科学]