肾周尿囊肿的诊断与治疗

目的探讨肾周尿囊肿的早期诊断与合理治疗。方法回顾分析６例肾周尿囊肿：５例有外伤史，１例有输尿管结石、肾积水史，术前经Ｂ超、逆行肾盂造影（ＲＰＧ）、ＣＴ检查确诊，２例ＲＰＧ检查发现瘘管。结果手术治疗４例：肾切除１例，囊肿去顶术３例，其中２例加瘘管切除；２例经皮穿刺引流后治愈。术后随访４个月～７年，囊肿无复发。结论肾周尿囊肿经Ｂ超筛选，结合ＲＰＧ、ＣＴ检查可明确诊断。早期发现且无输尿管梗阻者首选囊肿穿刺引流治疗，有瘘管或有输尿管梗阻者宜手术治疗原发病，同时处理囊肿并切除瘘管。

Diagnosis and treatment of urinoma

bjective To study the early diagnosis and appropriate treatment of urinoma. Methods Retrospective analysis of 6 cases of urinoma has been made,2 of the patients being male and 4 female.A past history of trauma was noted in 5 cases.The other patient had a past history of ureterolithiasis and hydronephrosis.Perirenal fluid has been demonstrated preoperatively on ultrasonography in all. ResultsA fistula was found in 2 on retrograde pyelogram and a cyst in 2 on CT scanning.All the 6 patients have been cured of the disease with no recurrence during the 4 month to 7 years' follow up.Open surgery has been carried out in 4,including 1 nephrectomy,3 partial cystectomy with concomitant fistulectomy in 2 of them.The other 2 patients underwent percutaneous catheter drainage. Conclusions In the absence of fistula or ureteral obstruction,aspiration and drainage of the cyst is the treatment of choice.Otherwise,open surgery is indicated.