成年人膀胱輸尿管逆流

Vesicoureteral Reflux in Adults

許明輝(Ming-Huei Sheu) ； 王家槐(Jia-Hwia Wang) ； 吳東霖(Dong-Lin Wu) ； 張遵(Tsuen Chang)

《中華放射線醫學雜誌》 18卷1期 (1993/03) Pp. 27-32

摘要

自1988年7月起3年間共收集了39位成人膀胱輸尿管逆流病例，12例為原發性逆流，其主要的臨床症狀為尿路感染(75%)及腰痛(34%)。另27例為繼發性逆流，主要原因為膀胱出口處阻塞(37%)（如尿道狹窄，前列腺肥大等），和經膀胱手術後所見之膀胱陰道或膀胱直腸瘻管，及經尿道前列腺切除，經尿道膀胱腫瘤切除後所引起之有關的症狀(34%)。有18例接受靜脈注射尿路攝影，從這些檢查中，發現有如下的異常：(A)集尿系統擴大（包括腎內及腎外部份）(17%)(B)輸尿管下三分之一段呈現不成比例的擴大(39%)(C)上述兩種現象同時顯現(22%)(D)逆流性腎病變(11%)。在靜脈注射尿路攝影中發現的腎內集尿系統擴大，常併有較高等級的逆流（第三級以上）。我們同時發現一例在成年後（50歲）才發生的兩側逆流性腎病變，一併報告之。

關鍵字

膀胱病變 ； 膀胱輸尿管逆流 ； 靜脈注射尿路攝影 ； 解尿性膀胱尿道攝影 ； 逆流性腎病變

並列摘要

Thirty-nine cases of vesico-ureteral reflux (VUR) in adult were found from July 1988 to June 1991. Twelve cases were primary VUR with the chief complaints of UTI (75%) and flank pain (34%), and 27 cases were secondary VUR either with the main problems of bladder outlet obstruction (37%) (including urethral stricture and prostate enlargement) or VUR found in the follow-up examination after previous surgical procedures on the urinary bladder (34%) (including vesico-vaginal or vesico-rectal fistula, TURP and TURBT). Positive findings in 18 cases of IVU study included: (A) dilated collecting system in both intra- and extra- renal portion (17%), (B) disproportionately widening of L/3 ureter (39%), (C) the combination of A and B (22%), and (D) reflux nephropathy (11%). Dilatation of intra-renal collecting system (group A and C) was usually associated with high grade VUR (above grade 3).
A case of adult-onset reflux nephropathy (with focal renal scarring in one kidney and diffused reflux atrophy in the other) was also reported.

並列關鍵字

Bladder, abnormality ； Bladder, radiography ； Kidney, abnormality ； Ureter, reflux ； Urography