男孩原位输尿管膨出膀胱下梗阻1例

A. A. Bebenina, O. Mokrushina, M. Levitskaya, V. Shumikhin, Nadezhda N. Erokhina
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摘要

背景。输尿管囊肿是输尿管末端的囊性扩张。原位输尿管囊肿是一种相对罕见的疾病,常见于女性儿童。原位输尿管囊肿的临床表现通常不明显,治疗方法也不清楚。临床病例描述。超声显示8个月大男孩左侧输尿管远端扩张(达6.5 mm),膀胱囊肿形成(直径8 mm,壁厚)。逆行排尿膀胱输尿管造影未显示膀胱输尿管反流迹象。评估排尿节律:残余尿量> 30%,提示膀胱下梗阻。患儿行诊断性膀胱输尿管镜检查、经尿道输尿管囊肿切除术、左输尿管置管(所有手术均在全身麻醉下进行)。术后12个月泌尿系统超声检查未见肾盂系统及输尿管肿大。临床尿检无炎症改变。排尿节律无病理变化。高科技和微创诊断和管理方法的广泛实施,使我们能够及时发现并提供有效的治疗儿童输尿管囊肿。
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Infravesical Obstruction in a Boy with Orthotopic Ureterocele: Clinical Case
Background. Ureterocele is a cystic dilatation of the distal ureter. Orthotopic ureterocele is relatively rare form of this disease, and it is commonly diagnosed in female children. The clinical picture of orthotopic ureterocele is usually not significant, and the management variants are unclear. Clinical case description. Ultrasound has revealed dilatation in the distal part of the left ureter (up to 6.5 mm) and cyst formation (diameter of 8 mm, thick walls) in the bladder in 8-months-old boy. The retrograde voiding cystourethrogram has shown no signs of vesicoureteral reflux. The evaluation of the voiding rhythm was performed: the volume of residual urine was > 30%, it indicates the infravesical obstruction. The child underwent diagnostic cystourethroscopy, transurethral resection of the ureterocele, intubation ureteral catheter in the left ureter (all procedures was performed under general anesthesia). There were no enlargements of calices-pelvis system and ureters 12 months after surgery according to urinary system ultrasound. Clinical urine test with no inflammatory changes. Voiding rhythm was without pathology.Conclusion. The widespread implementation of high-tech and minimally invasive methods of diagnosis and management allow us to achieve timely detection and provide effective treatment for children with ureterocele.
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