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目的:探讨子宫内膜异位症累及输尿管的诊断和治疗方法。方法:术前诊断为右侧输尿管下段占位病变伴右肾积水的42岁女性患者,行下腹正中切口,探查右侧输尿管开口处可见淡黄色息肉样病变,突入膀胱,输尿管下段增粗并全程扩张积水,行输尿管下段并膀胱袖式切除,输尿管膀胱再植术。术后病理报告为输尿管子宫内膜异位症。结果:术后复查B超示右肾积水较术前恢复,术后予抑那通3.75mg/28d,随访6个月未见复发。结论:对于输尿管占位并上尿路积水的女性患者,除考虑肿瘤外还应考虑子宫内膜异位症可能。手术联合内分泌治疗是治疗输尿管子宫内膜异位伴肾积水的有效方法。
Objective: To investigate the diagnosis and treatment of ureter involving endometriosis. Methods: A 42-year-old female with right hydronephrosis and right lower ureter obstruction was diagnosed preoperatively. The lower abdominal median incision was performed. The pale yellow polypoid lesions were seen in the opening of the right ureter, penetrating into the bladder and the lower ureter was thickened Expand the water throughout the line of the lower ureter and bladder sleeve resection, ureteral bladder replantation. Postoperative pathology was reported for ureteral endometriosis. Results: Postoperative B-scan showed that the hydronephrosis of the right kidney was recovered before operation, and was delayed to 3.75 mg / 28 days after operation. No recurrence was observed after 6 months of follow-up. Conclusions: For female patients with ureteral obstruction and upper urinary tract hydronephrosis, the possibility of endometriosis should be considered in addition to considering the tumor. Surgery combined with endocrine therapy is an effective method for the treatment of ureteral endometriosis with hydronephrosis.