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首页> 外文期刊>BJU international >The neonatal management and surgical correction of urinary hydrometrocolpos caused by a persistent urogenital sinus.
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The neonatal management and surgical correction of urinary hydrometrocolpos caused by a persistent urogenital sinus.

机译：由持续性泌尿生殖窦引起的尿液积水的新生儿管理和手术矫正。

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OBJECTIVE: To define the neonatal management and ultimate surgical correction via the anterior sagittal transanorectal approach (ASTRA) in cases of neonatal urinary hydrometrocolpos associated with a persistent urogenital sinus (UGS). PATIENTS AND METHODS: We report three patients with UGS (with no ambiguous genitalia) and urinary hydrometrocolpos in whom prenatal ultrasonography showed cystic dilatation of the pelvis. Two patients were temporarily treated with intermittent vaginal catheterization and antibiotic prophylaxis, and in one a cystostomy was necessary to temporarily drain the urine. At the age of 6-8 months the patients underwent reconstructive surgery of the UGS via the ASTRA, under a previous protective colostomy. RESULTS: The mean (range) age of the patients at the last follow-up was 18.7 (8-32) months. A good cosmetic result was obtained in all patients. The vagina was dilated briefly with no anaesthesia in each patient. Patients had normal faecal control after the colostomy was closed and none had urinary incontinence. CONCLUSIONS: When possible, intermittent vaginal catheterization permits sufficient temporary drainage of the urinary hydrometrocolpos associated with a persistent UGS. Subsequent ASTRA allows good exposure of the UGS, assuring the preservation of the anorectal innervation and of the sphincteric mechanism.
机译：目的：通过伴有持续性泌尿生殖窦（UGS）的新生儿泌尿积水术，定义通过前矢状经肛门直肠入路（ASTRA）的新生儿管理和最终手术矫正。病人和方法：我们报告了三例UGS（无歧义生殖器）和尿液积水的患者，产前超声检查显示骨盆囊性扩张。两名患者接受了间歇性阴道导管插入术和抗生素预防措施的临时治疗，其中一名患者必须行膀胱造瘘术才能暂时排干尿液。在6-8个月大时，患者在先前的保护性结肠造口术下通过ASTRA进行了UGS的重建手术。结果：最后一次随访的患者平均（范围）年龄为18.7（8-32）个月。所有患者均获得良好的美容效果。每个病人的阴道都短暂扩张，没有麻醉。结肠造口关闭后患者的粪便控制正常，无尿失禁。结论：在可能的情况下，间歇性阴道导管插入术可使与持续性UGS相关的尿液积水充分临时引流。随后的ASTRA可使UGS良好暴露，从而确保保留肛门直肠神经支配和括约肌机制。

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