胚胎移植术前发现重复右肾、输尿管伴输尿管异位开口于阴道1例  

Diagnosis of duplicated kidney and ureter with ectopic opening of ureter in vagina before embryo transfer

作　　者：田烨 李芳[1] 张静[1] 夏辉 陈琪[1] 罗营[1] 宋学茹[1] Tian Ye;Li Fang;Zhang Jing;Xia Hui;Chen Qi;Luo Ying;Song Xueru(Department of Gynecology and Obstetrics,Tianjin Medical University General Hospital/Tianjin Key Laboratory of Female Reproductive Health and Eugenics,Tianjin Medical University General Hospital,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院妇产科、天津市女性生殖健康与优生重点实验室,天津300052

出　　处：《中华生殖与避孕杂志》2024年第12期1281-1284,共4页Chinese Journal of Reproduction and Contraception

基　　金：国家自然科学基金面上项目(82171625);天津市医学重点学科(专科)建设项目(TJYXZDXK-031A)。

摘　　要：回顾分析1例胚胎移植术前发现重复右肾、输尿管伴输尿管异位开口于阴道的病例并进行文献复习。该患者拟行第3次胚胎移植,移植术前因"右输卵管积水"行腹腔镜下双侧输卵管切除术,术后1周余开始出现阴道持续分泌物增多伴异味50 d余,门诊反复抗炎治疗无效。阴道超声检测见右附件区囊肿,后经多次妇科检查、阴道超声、泌尿系超声、全腹CT、磁共振泌尿系水成像等检查诊断为右肾、输尿管畸形伴输尿管异位开口于阴道。复读患者输卵管切除术前影像,发现扩张的右重复输尿管被误诊为右输卵管积水。女性附件区囊肿伴持续阴道流液需考虑有无重复输尿管合并输尿管异位开口的可能,应注意与输卵管积水鉴别。A retrospective analysis was conducted on a case of duplicate right kidney and ureter with ectopic opening in the vagina discovered before embryo transfer,and literature review was conducted.The patient planned to undergo a third embryo transfer.Prior to the transfer,laparoscopic bilateral salpingectomy was performed due to"right fallopian tube hydrosalpinx".About a week after the surgery,there was a continuous increase in vaginal discharge with an odor for more than 50 d.Repeated antibiotic treatments in the outpatient department were ineffective.Vaginal ultrasound examination revealed a cyst in the right adnexal area.After multiple gynecological examinations,vaginal ultrasound,urological ultrasound,whole abdominal CT,magnetic resonance urography,etc.,the diagnosis was right kidney and ureteral malformation with ectopic opening of the ureter in the vagina.Upon reviewing the preoperative images of the patient undergoing salpingectomy,it was found that the dilated right repeated ureter was misdiagnosed as hydrosalpinx.Women with adnexal cysts accompanied by continuous vaginal discharge should consider the possibility of repeated ureters and ectopic ureteral opening,and should pay attention to distinguishing it from hydrosalpinx.

关 键 词：泌尿生殖系统畸形 输尿管疾病 输卵管疾病 鉴别诊断 

分 类 号：R71[医药卫生—妇产科学]