Uterine Retroversion Related to Unilateral Hydronephrosis and Acute Renal Colic: A Case Report

子宮後傾導致單側腎水腫及急性腎絞痛：個案報告

梁宏華(Hung-Hua Liang) ； 黃建榮(Andy C. Huang) ； 李泓家(Hung-Chai Li) ； 黃銘德(Ming-Te Huang) ； 鄢源貴(Yuen-Kui Yen) ； 葉劭德(Shauh-Der Yeh) ； 江漢聲(Han-Sun Chiang) ； 劉明哲(Ming-Che Liu)

《輔仁醫學期刊》 5卷1期 (2007/03) Pp. 53-56

摘要

背景和目的：子宮後傾或脫垂於婦科並不少見，一般大多不具症狀或症狀輕微不需侵入性治療.但是當明顯造成不孕、疼痛或尿滯留時，則需輔以手術矯正。手術方法則有傳統閉腹手術及腹腔鏡子宮懸吊術。個案報告：一名24歲女性，未有懷孕或生產史，因急性腎絞痛而至急診求助。腎臟超音波發現輕度右腎積水。而腎盂造影則發現右側輸尿管有向外側偏移現象，疑受骨盆腔腫塊壓迫。腹部電腦斷層則顯現子宮後傾合併壓迫右側輸尿管。在腹腔鏡子宮懸吊術之後，患者之腎積水及腎絞痛症狀完全康復。討論：子宮的解剖位置改變常見於多產婦。在未有懷孕及生產史的患者，子宮後傾通常為無症狀的先天變異。但是在我們的病例報告中，因子宮後傾而導致之輸尿管壓迫及腎積水可以說是相當罕見。腹腔鏡子宮懸吊術將子宮復位，是微創手術同時也具有滿意的療效。

關鍵字

子宮後傾 ； 腎積水 ； 腹腔鏡子宮懸吊術

並列摘要

Uterine retroversion is not rare in reproductive women but is usually asymptomatic. Surgical intervention is indicated when it becomes symptomatic or related to infertility. Curable options by uterine suspension include a laparotomy or laparoscopy. A 24-year-old female patient came to the emergency department for help due to acute renal colic pain. Renal ultrasonography revealed mild right hydronephrosis. Intravenous pyelography revealed mild right hydronephrosis with lateral deviation of the right ureter. Obstructive uropathy due to external mass compression was suspected. Abdominal computed tomography revealed uterine retroversion with lateral deviation of the right ureter. A gynecologist was consulted and laparoscopic uterine suspension was performed. During the follow up, the right hydronephrosis subsided, and she was free of hematuria and renal colic pain. Uterine retroversion occurs in 20%-30% of women and is often an asymptomatic normal variant. In our case, the mass effect of the retroverted uterus which changed the uterine axis caused the obstructive uropathy. We suggest that laparoscopic uterine suspension is a curative and minimally invasive treatment.

並列關鍵字

uterine retroversion ； obstructive uropathy