輸尿管重植手術治療異位性輸尿管及異位性輸尿管膨出的結果分析
鄭鴻琳* 邱元佑
國立成功大學醫學院暨附設醫院泌尿部* 小兒科部
Clinical Outcome of Ureteral Reimplantation in the Treatment of Ectopic Ureter and Ectopic Ureterocele
Hong-Lin Cheng* Yuan-Yow Chiou
Departments of Urology*and Pediatrics, Medical College and Hospital, National Cheng Kung University, Tainan, Taiwan
Purpose: Ectopic ureter and ectopic ureterocele is a rare and complicated congenital ureteral anomalies. It usually presented with febrile urinary tract infection FUTI) and hydronephrosis , and commonly resulted in vesicoureteral reflux (VUR)in lesion side or contralateral side. Herein, we reported our experience in the surgical treatment of ectopic ureter and ectopic ureterocele.
Materials and Methods: From March in 2008 to December in 2017, a total of 19 patients, female 13 and male 6, was enrolled in this retrospected study. Besides 1 female adult, the median age at the operation was 5.25 months (18 days - 5 years and 6 months). Initial presentation was FUTI, 11 and hydronephrosis, 8. Duplicated system of kidney included 9 patients (right 5 and left 4), while single system 10 (right 6 and left 4). Of the VUR, 5 was at the same side and 2 at the opposite side. Follow-up time was at least 3 months after surgery.
Results: Of the surgical procedures, 16 were primary ureteral reimplantation (+/_ ureterocele excision), 1 TUI, 1 cystoscopy and 1 total removal. Besides primary ureteral reimplantation, ureteral reimplantation in the contralateral side was 2 and re-do was 1. For the hydronephrosis, 100% (8/8) improved and 50% (4/8) preserved a little renal function in single system; meanwhile 100% (9/9) improved and 22% (2/9) preserved obvious renal cortex in the duplex system. For FUTI, 84% (16/19) was subsided.
Conclusions: Ureteral reimplantation in the treatment of ectopic ureter and ectopic ureterocele in young age can improve FUTI control, hydronephrosis and may preserve renal function.