女性尿道憩室:当代综述

Joana Briosa Neves , João Almeida Dores , Manuel Ferreira Coelho
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引用次数: 0

摘要

尿道憩室影响0.6%至4.7%的女性,是持续性泌尿系统症状的常见原因,并可出现结石和恶性肿瘤等并发症。今天,女性尿道憩室的诊断不足和诊断治疗延迟仍然很常见。本文的目的是分析有关该病的伦理学、诊断和治疗的技术现状。材料与方法通过数据库Medline检索关键词:“女性尿道憩室”、“女性尿道憩室”、“尿道憩室”、“尿道憩室”、“女性尿道”,对2014年1月前发表的文章进行文献修订;以及所获文章的参考书目。结果女性尿道憩室多继发于尿道周围及尿道腺感染。尽管排尿困难、性交困难和尿后滴尿是典型的三联征,但临床表现多样且不特异性。超过三分之一在妇科检查时可触及。影像学检查,即磁共振和超声,具有很高的诊断能力,有助于手术计划。根据位置、构象和相关症状,尿道憩室可以保守治疗,更常见的是手术治疗。讨论女性尿道憩室的诊断仍需临床评估。目前,磁共振被认为是诊断憩室和排除术前和术后并发症的最佳方式。侵入性较小的技术已被描述,但经阴道尿道憩室切除术产生最高的治愈率。结论提高医学界的认识是减少女性尿道憩室漏诊和延误诊断的最有力武器。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Divertículos da uretra feminina: uma revisão contemporânea

Introduction

Urethral diverticula affect from 0.6 to 4.7% of women, are a frequent cause of persistent urinary symptoms and can present with complications such as lithiasis and malignization. Today, underdiagnosis and diagnostic and therapeutic delay of female urethral diverticula are still common. The aim of this article is to analyse the state of art regarding ethiology, diagnosis and therapeutics of this disease.

Materials and methods

Bibliographic revision of articles published until January/2014 after search of the database Medline for the keywords: “female urethral diverticula”, “female urethral diverticulum”, “urethral diverticula”, “urethral diverticulum” and “female urethra”; and of bibliographic references of the articles obtained.

Results

Most female urethral diverticula are secondary to infection of the periurethral and urethral glands. Despite the classically described triad of dysuria, dyspareunia and post‐void dribbling, the clinical manifestations are diverse and unspecific. Over a third are palpable on gynaecologic examination. Imaging exams, namely magnetic resonance and ultrasound, have high diagnostic capability and contribute to surgical planning. Depending on location, conformation and associated symptoms, urethral diverticula can be managed conservatively or, more frequently, surgically.

Discussion

Clinical evaluation is still essential for the diagnosis of female urethral diverticula. Currently, magnetic resonance is considered to be the best modality to diagnose the diverticula and to exclude pre‐ and post‐operative complications. Less invasive techniques have been described but transvaginal urethral diverticulectomy yields the highest symptomatic cure rates.

Conclusion

Awareness of the medical community is the most powerful weapon to reduce the underdiagnosis and diagnostic delay associated with female urethral diverticula.

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