完全性雙套輸尿管併有異位性輸尿管開口以及應力性尿失禁－病例報告

Complete Duplication of Ureter Associated with Ectopic Ureteral Orifice and Genuine Stress Incontinence – A Case Report

郭漢崇(Hann-Chorng Kuo)

《慈濟醫學雜誌》 4卷2期 (1992/06) Pp. 119-123

https://doi.org/10.6440/TZUCMJ.199206.0119

摘要

一位33歲女性病人自少女時期起即有間歇性尿失禁現象，結婚生子後尿失標更為嚴重。檢查時發現病人有第四類應力性尿失禁，經膀胱頸懸吊術後仍有尿失禁現象，再經詳細檢查才發現病人有一異位性輸尿管開口於尿道口外側，上方為完全性雙套輸尿管及一極小之腎單位。我們再為病人施行下端輸尿管吻合術後才治癒其尿失禁。由於合併兩種尿失禁較少見，且容易忽略另一種診斷，特此提出病例報告。

關鍵字

尿失禁 ； 異位性輸尿管開口

並列摘要

A 33 year-old woman suffered from intermittent urinary incontinence since her teen age, the incontinence exacerbated after delivery of two children. Physical examination revealed a type 4 genuine stress incontinence and endoscopic bladder neck suspension was undertaken. However, after operation, persistent urine leakage was noted when large amount of intravenous fluid was given. Further examination and probing found an ectopic ureteral orifice existing in the vaginal vestibule. Retrograde catheterization and pyelopgraphy revealed the ectopic ureter drained a small upper segment of the left kidney. A second surgery was carried out to anastomose ectopic ureter to the normal ureter and the left kidney. A second surgery was carried out to anastomose ectopic ureter to the normal ureter and the patient regained her continence after operation.
For patients with urinary incontinence, coexistence of ectopic ureter and genuine stress incontinence is possible. The lesson of this unusual case teaches us detailed physical examination and interpretation of urography is necessary in order to rule out other possibility of urinary incontinence although a frank diagnosis has presented.

並列關鍵字

urinary incontinence ； ectopic ureter