尿管瘤
WordNet
- prolapse of the end of the ureter into the bladder; may obstruct urine flow
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/07/03 19:27:51」(JST)
[Wiki en表示]
Not to be confused with Urethrocele.
| Ureterocele |
|
| Classification and external resources |
| ICD-10 |
N28.8 |
| ICD-9 |
593.89, 753.23 |
| DiseasesDB |
33455 |
| MedlinePlus |
000462 |
| eMedicine |
radio/729 |
| MeSH |
D014518 |
A ureterocele is a congenital abnormality found in the ureter. In this condition called ureteroceles, the distal ureter balloons at its opening into the bladder, forming a sac-like pouch. It is most often associated with a duplicated collection system, where two ureters drain their respective kidney instead of one. Simple ureteroceles, where the condition involves only a single ureter, represents only twenty percent of cases. Ureteroceles affects one in 4,000 individuals, at least four-fifths of whom are female. Patients are frequently Caucasian.
Since the advent of the ultrasound, most ureteroceles are diagnosed prenatally. The pediatric and adult conditions are often found only through diagnostic imaging performed for reasons other than suspicious ureteroceles.
Contents
- 1 Classification
- 2 Signs and symptoms
- 3 Complications
- 4 Causes
- 5 Treatment
- 6 References
Classification
- Intravesical
- Confined within the bladder
- Ectopic
- Some part extends to the bladder neck or urethra
- Stenotic
- Intravesical ureterocele with a narrow opening
- Sphincteric
- Ectopic ureterocele with an orifice distal to the bladder neck
- Sphincterostenotic
- Orifice is both stenostic and distal to the bladder neck
- Cecoureterocele
- Ectopic ureterocele that extends into the urethra, but the orifice is in the bladder
Signs and symptoms
CT scan showing a ureterocele associated with a duplicated collection system of the left kidney.
The signs and symptoms of ureteroceles in the latter two forms can easily be confused with other medical conditions. Symptoms can include:
- Frequent urinary tract infection
- Urosepsis
- Obstructive voiding symptoms
- Urinary retention
- Failure to thrive
- Hematuria
- Cyclic abdominal pain
- Ureteral calculus
- cobra head sign is seen in radiography.
- In females-Salpingitis, Hydrosalpinx with sepsis or torsion. T.O. mass.
Complications
Many other complications arise from ureteroceles. Redundant collection systems are usually smaller in diameter than single, and predispose the patient to impassable kidney stones. The effective "bladder within a bladder" compounds this problem by increasing the collision of uric acid particles, the process by which uric acid stones are formed. Ureteroceles is also associated with poor kidney function. It can cause frequent blockage of the ureter leading to serious kidney damage. In other cases, a small, upper portion of the kidney is congenitally non-functional. Though often benign, this problem can necessitate the removal of non-functioning parts.
Causes
Definitive causes of ureteroceles have not been found. While the abnormal growth occurs within the uterus, it has not been substantiated that genetics are to blame.
Treatment
- Single-system ureterocele Initial management is usually endoscopic incision of the ureterocele, which can be followed by surgical ureteric re-implantation to preserve renal function and prevent reflux.
- Duplex-system ureterocele Treatment options vary with the individual and include: endoscopic incision of the corresponding ureteric orifice in case of ureteric meatal stricture; upper pole nephrectomy for a poorly functioning unit with ureterectomy or, where there is useful renal function, ureteropyelostomy can be performed.
References
- Hautmann, Huland: Urologie, 3.Auflage, Springer Verlag 2006, S397 f (German)
- W. Schuster, D. Färber (Hrsg.): Kinderradiologie. Bildgebende Diagnostik. Springer 1996, ISBN 3-540-60224-0 (German)
- M. Bettex, N. Genton, M. Stockmann (Hrsg.): Kinderchirurgie. Diagnostik, Indikation, Therapie, Prognose. 2. Auflage, Thieme 1982, ISBN 3-13-338102-4 (German)
- V. Hofmann, K. H. Deeg, P. F. Hoyer: Ultraschalldiagnostik in Pädiatrie und Kinderchirurgie. Lehrbuch und Atlas. Thieme 2005, ISBN 3-13-100953-5. (German)
- F. C. Sitzmann: Kinderheilkunde. Diagnostik - Therapie - Prophylaxe. 6. Auflage, Hippokrates 1988, ISBN 3-7773-0827-7. (German)
- Urinary system
- Pathology
- Urologic disease / Uropathy (N00–N39, 580–599)
|
|
| Abdominal |
Nephropathy/
(nephritis+
nephrosis) |
Glomerulopathy/
glomerulitis/
(glomerulonephritis+
glomerulonephrosis) |
Primarily
nephrotic |
| Non-proliferative |
- Minimal change
- Focal segmental
- Membranous
|
|
| Proliferative |
- Mesangial proliferative
- Endocapillary proliferative
- Membranoproliferative/mesangiocapillary
|
|
| By condition |
|
|
|
Primarily
nephritic,
RPG |
| Type I RPG/Type II hypersensitivity |
|
|
| Type II RPG/Type III hypersensitivity |
- Post-streptococcal
- Lupus
- IgA/Berger's
|
|
| Type III RPG/Pauci-immune |
- Granulomatosis with polyangiitis
- Microscopic polyangiitis
- Churg–Strauss syndrome
|
|
|
|
Tubulopathy/
tubulitis |
| Proximal |
|
|
| Thick ascending |
|
|
| Distal convoluted |
|
|
| Collecting duct |
- Liddle's syndrome
- RTA
- Diabetes insipidus
|
|
| Renal papilla |
|
|
| Major calyx/pelvis |
- Hydronephrosis
- Pyonephrosis
- Reflux nephropathy
|
|
| Any/all |
|
|
|
| Interstitium |
- Interstitial nephritis
- Pyelonephritis
- Danubian endemic familial nephropathy
|
|
| Any/all |
| General syndromes |
- Renal failure
- Acute renal failure
- Chronic kidney disease
- Uremic pericarditis
- Uremia
|
|
| Vascular |
- Renal artery stenosis
- Renal ischemia
- Hypertensive nephropathy
- Renovascular hypertension
- Renal cortical necrosis
|
|
| Other |
- Analgesic nephropathy
- Renal osteodystrophy
- Nephroptosis
- Abderhalden–Kaufmann–Lignac syndrome
|
|
|
|
| Ureter |
- Ureteritis
- Ureterocele
- Megaureter
|
|
|
| Pelvic |
| Bladder |
- Cystitis
- Interstitial cystitis
- Hunner's ulcer
- Trigonitis
- Hemorrhagic cystitis
- Neurogenic bladder dysfunction
- Bladder sphincter dyssynergia
- Vesicointestinal fistula
- Vesicoureteral reflux
|
|
| Urethra |
- Urethritis
- Non-gonococcal urethritis
- Urethral syndrome
- Urethral stricture/Meatal stenosis
- Urethral caruncle
|
|
|
| Any/all |
- Obstructive uropathy
- Urinary tract infection
- Retroperitoneal fibrosis
- Urolithiasis
- Bladder stone
- Kidney stone
- Renal colic
- Malakoplakia
- Urinary incontinence
|
|
|
Index of the urinary system
|
|
| Description |
- Anatomy
- Physiology
- Development
- Cells
|
|
| Disease |
- Electrolyte and acid-base
- Congenital
- Neoplasms and cancer
- Other
- Symptoms and signs
- Urine tests
- Blood tests
|
|
| Treatment |
- Procedures
- Drugs
- Intravenous fluids
|
|
|
UpToDate Contents
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- 1. 尿管瘤 ureterocele
- 2. 胎児水腎症の概要 overview of antenatal hydronephrosis
- 3. 胎児水腎症の産後マネージメント postnatal management of antenatal hydronephrosis
- 4. 先天性腎尿路異常（CAKUT）の概要 overview of congenital anomalies of the kidney and urinary tract cakut
- 5. 女性における尿道憩室 urethral diverticulum in women
English Journal
- Endoscopic correction of complex cases of vesicoureteral reflux utilizing Vantris as a new non-biodegradable tissue-augmenting substance.
- Chertin B1, Arafeh WA, Kocherov S.Author information 1Department of Pediatric Urology, Shaare Zedek Medical Center, Faculty of Medical Science, Hebrew University, P.O.B 3235, 91031, Jerusalem, Israel, boris.chertin@gmail.com.AbstractPURPOSE: We aimed to evaluate prospectively the efficacy of Vantris as a new non-biodegradable tissue-augmenting substance in children with complex cases of VUR.
- Pediatric surgery international.Pediatr Surg Int.2014 Apr;30(4):445-8. doi: 10.1007/s00383-014-3468-z.
- PURPOSE: We aimed to evaluate prospectively the efficacy of Vantris as a new non-biodegradable tissue-augmenting substance in children with complex cases of VUR.MATERIALS AND METHODS: Over the last 4 years, 37 children (28 female and 9 male) with a mean age of 5.8 ± 3.1 years (mean ± SD) und
- PMID 24448911
- Noninvasive ureterocele puncture using pulsed focused ultrasound: an in vitro study.
- Maxwell AD1, Hsi RS, Bailey MR, Casale P, Lendvay TS.Author information 11 Department of Urology, University of Washington School of Medicine , Seattle, Washington.AbstractAbstract Purpose: To evaluate the feasibility of performing noninvasive puncture of pediatric ureteroceles with cavitation-based focused ultrasound (US) (histotripsy). Materials and Methods: A model for the ureterocele wall was developed from an excised bovine bladder wall. The model was exposed to focused US pulses in a water bath under three different US parameter sets for up to 300 seconds to create localized perforations in the wall. B-mode US imaging was used to monitor the treatment and assess potential imaging guidance and feedback. Results: Punctures were formed between 46-300 seconds, depending on the focused US exposure parameters and model wall thickness. Puncture diameter was controllable through choice of exposure parameters and could be varied between 0.8-2.8 mm mean diameter. US-induced cavitation was visible on B-mode imaging, which provided targeting and treatment feedback. Conclusions: Cavitation-based focused US can create punctures in a model that mimics the tissue properties of a ureterocele wall, under guidance from US imaging.
- Journal of endourology / Endourological Society.J Endourol.2014 Mar;28(3):342-6. doi: 10.1089/end.2013.0528. Epub 2013 Dec 27.
- Abstract Purpose: To evaluate the feasibility of performing noninvasive puncture of pediatric ureteroceles with cavitation-based focused ultrasound (US) (histotripsy). Materials and Methods: A model for the ureterocele wall was developed from an excised bovine bladder wall. The model was exposed to
- PMID 24171441
- Prolapse of a single system large ureterocele containing multiple stones in a pregnant woman.
- Scovell JM1, Chan RC2, Khavari R2.Author information 1Baylor College of Medicine, Houston, TX. Electronic address: scovell@bcm.edu.2Department of Urology, Houston Methodist Hospital, Houston, TX.AbstractPeriurethral masses are uncommon in adult women, with little guidance on initial management. We describe a case of a 29-year-old pregnant woman with a single-system ureterocele prolapse complicated by multiple calculi ranging from 1 to 2.5 cm.
- Urology.Urology.2014 Mar;83(3):e3-4. doi: 10.1016/j.urology.2013.11.021.
- Periurethral masses are uncommon in adult women, with little guidance on initial management. We describe a case of a 29-year-old pregnant woman with a single-system ureterocele prolapse complicated by multiple calculi ranging from 1 to 2.5 cm. Copyright © 2014 Elsevier Inc. All rights reserved.
- PMID 24581544
Japanese Journal
- 症例報告 片側異所性尿管瘤により排尿困難を呈したネコの1例
- 症例報告 膀胱尿管逆流を伴った左異所性尿管瘤の1女児例
- 横西 哲広,伊藤 悠亮,松本 達也
- 泌尿器科紀要 56(7), 385-387, 2010-07
- … We report a case of prolapse of a simple ureterocele presenting as perineural tumor. … However, just before resection the mass collapsed spontaneously and turned out to be a prolapse of ureterocele. … Physicians should consider prolapse of a simple ureterocele in the differential diagnosis of the female meatal tumor. …
- NAID 120002381094
Related Links
- A ureterocele is a cystic dilatation of the terminal ureter within the bladder and/or the urethra (). It may present as an incidental finding on antenatal ultrasonography, or postnatally because of symptoms due to urinary tract infection or ...
- ureterocele /ure·tero·cele/ (u-re´ter-o-sēl″) sacculation of the terminal portion of the ureter into the bladder, as a result of stenosis of the ureteral meatus. u·re·ter·o·cele (yo o-rē′tə-rō-sēl′) n. Saccular dilation of the terminal portion of the ...
Related Pictures
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- 英
- ureterocele
- 関
- 先天性水腎症、尿管
概念
- 尿管下端部が嚢状に拡張した先天異常で、女性に多い。
- 尿管瘤の開口部位により2つに分けられる。
- 膀胱内尿管瘤：尿管の下端部が嚢状に拡張し、膀胱三角部の正常な位置に開口する。尿管口粘膜の先天性狭窄のため、腎から運ばれる尿は瘤内に一旦留まり緊満状態となった後に膀胱に排出される。従って、上部尿路の拡張と尿路感染を伴うことが多い。また嚢内に尿管結石を生じることが多い。
- 異所性尿管瘤：尿管の下端部が嚢状に拡張し、尿道などに開口する。