Diagnosis of the Congenital Urethral Anomalies of Male Child by Voiding Cystourethrography

男孩先天性尿道畸型是一罕見之先天性畸型，而且不容易診斷，其臨床表現大多以下尿道阻塞及感染爲主。民國84年3月至民國87年2月，本科共完成1246例男孩人次之放射線排尿時膀胱尿道攝影(Voiding Cystourethrography-VCUG)，吾人髮現7例先天尿道下裂以外之先天性尿道畸型。4型是後尿道瓣膜，前尿道瓣膜，前尿道憩室及巨大尿道等各一例。受檢患者的年齡從3天大新生兒到9歲男孩，當中有5例合併膀胱輸尿管逆流(Vesicoureteral re-flux-VUR)，2例後尿道瓣膜手術後仍然發生腎衰竭現象。3例合併腎臓發育不良，其臨床表現及VCUG檢查結果加以討論分析。VCUG的檢查方式本科是採取X光透視及同步照相來進行檢查。其檢查過程是將顯影劑由導尿管注入膀胱內，在X光透視下，觀察膀胱漲濔時，解尿時，解尿後的各種情況，觀察是否有膀胱輸尿管逆流的現象外，還須觀察男孩尿道有否異常，特別解尿時，斜位攝影對診斷很有幫助。放射線醫師判讀結果，可提供小兒科或小兒外科醫師作爲治療病人的依據，使病人能夠得到正確的治療，使其早日恢複健康。故VCUG不單只可以診斷兒童之膀胱輸尿管逆流，並可以安全正確的診斷男孩先天性尿道異常。

關鍵字

後尿道瓣膜；前尿道瓣膜；前尿道憩室；巨大尿道；排尿時膀胱尿道攝影

並列摘要

Congenital urethral anomalies in boys are rare.This report concerns seven children with congenital urethral anomalies other than hypospadias from March 1995 to February 1998. Seven cases of congenital urethral anomalies were diagnosed by voiding cystourethrography (VCUG)from 1246 examinations of boys over a period of three years. There were four posterior urethral valves, one anterior urethral valve, one anterior urethral diverticulum, and one megalourethra. Five of them had vesicoureteral reflux (VUR). Two cases of posterior urethral valve had renal failure in spite of surgery. Three cases exhibited renal cystic dysplasia. The clinical presentation and imaging findings are presented. Conventional fluoroscopically monitored VCUG is the principal examination used for bladder and urethra study in children. Therefore, in boys presenting the signs and symptoms related to voiding disturbance, VCUG is used to detect not only VUR but also anomalies in the bladder and urethra. In conclusion, VCUG is safe and essential for diagnosis of congenital urethral anomalies.

並列關鍵字

posterior urethral valve ； anterior urethral valve ； anterior urethral diverticulum ； megalourethra ； voiding cystourethrography

國際替代計量

Diagnosis of the Congenital Urethral Anomalies of Male Child by Voiding Cystourethrography

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