低压回肠“b”状膀胱成形术  

Nonpalpable testicular masses incidentally discovered by ultrasound

作　　者：侯成玉[1] 周荣祥[1] 孟凡学[1] 迟玉友[1] 燕东亮[1] 尹洪山[1] 

机构地区：[1]滨州医学院附属医院泌尿外科

出　　处：《中华外科杂志》1999年第3期165-167,共3页Chinese Journal of Surgery

摘　　要：目的探讨解决膀胱癌患者膀胱全切后的贮尿和排尿问题的方法。方法利用带蒂回肠段施行低压回肠“ｂ”状膀胱成形术１６例。结果术后新膀胱贮尿功能良好，经尿道排尿。通过残余尿测定、实验室及影像学检查，无水、电解质代谢紊乱，无输尿管返流，无尿失禁及肾功能损害，术后患者生活质量较高。结论该术式是一种理想的膀胱成形术式。Objective To determine the diagnosis and management of impalpable testicular masses detected sonographically. Methods We analyzed retrospectively the sonographic findings and pathologic results of such cases and reviewed related literature. Results In over 600 patients receiving scrotal ultrasound, 14 aged on average 42 4 years (14 to 71 years) had 16 impalpable testicular masses, with a diameter of 5 to 30 mm (mean 12 1mm). All masses were predominantly hypoechoic except for one appeared hyperechoic and calcified. Pathological examination showed 2 seminomas, 2 lymphomas, 2 testicular tuberculoses and cysts respectively. The other six were embryonal cell carcinoma, metastatic adenocarcinoma, testicular fibrosis, partial infarction, testis abscess, and hematoma. Malignant lesions accounted for 42 86%(6/14). In 13 of 14 patients, the affected testis was resected, while in 1 the testis spared for frozen sectioning revealed a benign cystic lesion. Conclusions Ultrasound findings can not differentiate malignant from benign in the impalpable lesions, and clinical history should be considered. All patients with indefinite diagnosis should undergo inguinal exploration and the testis can be spared if intraoperative frozen section diagnosis is negative.Ultrasound follow up should be used only if there is a strong evidence of infection or trauma.

关 键 词：膀胱肿瘤 膀胱切除术 贮尿 排尿 术式 

分 类 号：R737.140.5[医药卫生—肿瘤] R730.56[医药卫生—临床医学]