23例输尿管子宫内膜异位症患者诊断和治疗的临床分析

目的:总结23例输尿管子宫内膜异位症患者的临床诊断和治疗经验.方法:回顾性分析23例病理证实为输尿管子宫内膜异位症患者的临床诊治以及术后随访资料,并对结果进行对比分析.结果:23例患者均接受了超声检查,其中21例接受了静脉肾盂造影检查,11例接受了逆行肾盂造影检查,16例接受了CT检查,8例接受了MRI检查;23例均行手术治疗,其中3例接受了输尿管粘连松解术治疗,6例接受了输尿管狭窄段切除+输尿管膀胱再吻合术治疗,12例接受了输尿管狭窄段切除+输尿管端端吻合术治疗,2例接受了输尿管内镜下子宫内膜异位病损电灼术治疗.23例患者均为单侧发病,左侧14例,右侧9例.术后病理检查证实为子宫内膜异位症,异位病灶均位于输尿管下段.结论:输尿管子宫内膜异位症是一种泌尿外科罕见的疾病,早期诊断难度较大,影像学检查在输尿管子宫内膜异位症的诊断中起着重要作用.对于轻度的输尿管梗阻患者,推荐行输尿管粘连松解术治疗;对于中、重度输尿管梗阻患者,推荐行输尿管狭窄段切除术治疗;对于病变程度严重的病例,推荐术后应用激素类药物治疗降低术后的复发率.     

输尿管子宫内膜异位症伴肾积水1 例报告并文献复习

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。     

经阴道超声联合血清AFP、PAI-1及MMIF对子宫内膜异位症的诊断价值分析

摘要 目的：探讨经阴道超声联合血清甲胎蛋白（AFP）、纤溶酶原激活物抑制物1（PAI-1）及巨噬细胞移动抑制因子（MMIF）对子宫内膜异位症的诊断价值。方法：选取我院2021年8月到2023年8月收治的150例子宫内膜异位症患者进行回顾性分析,分析其经阴道超声检查图像特征,并以病理诊断作为"金标准",分析阴道超声对宫内膜异位症的阳性检出率。依照子宫内膜异位症分期,将其分为Ⅰ~Ⅱ期组（n=77）,Ⅲ~Ⅳ期组（n=73）,另选取同期来我院体检的150例健康女性作为对照组。分析三组受检者血清AFP、PAI-1及MMIF表达水平,并采用Spearman相关分析法分析AFP、PAI-1及MMIF与子宫内膜异位症的相关性。最后建立受试者特征（ROC）工作曲线分析经阴道超声联合血清AFP、PAI-1及MMIF对子宫内膜异位症的诊断效能。结果：150例子宫内膜异位症患者均经病理诊断确诊,通过经阴道超声检查确诊为子宫内膜异位症的患者128例,85.33%。其中75例患者为卵巢型,超声显示巨大巧克力囊肿,内部可见大量细密点状回声与分隔光带。53例患者为子宫型,超声显示后壁腺肌瘤,内部回声不均匀,可见片状无回声区域;三组受检者血清AFP、PAI-1及MMIF表达水平对比差异显著,Ⅲ~Ⅳ期组明显高于Ⅰ~Ⅱ期组和对照组,差异具有统计学意义（P＜0.05）;Spearman相关分析结果显示：AFP、PAI-1及MMIF与子宫内膜异位症呈正相关（P＜0.05）;诊断灵敏度和特异度从低到高依次为MMIF（52.58%、64.32%）、PAI-1（60.03%、67.53%）、AFP（65.24%、71.27%）、经阴道超声（73.25%、86.36%）、经阴道超声联合血清AFP、PAI-1及MMIF（84.26%、98.63%）。经阴道超声联合血清AFP、PAI-1及MMIF的诊断灵敏度明显高于单一指标诊断（P＜0.05）。结论：经阴道超声联合血清AFP、PAI-1及MMIF对子宫内膜异位症的诊断价值较高,其灵敏度和特异度分别为84.26%、98.63%,通过联合诊断可进一步辅助减少子宫内膜异位症的误诊和漏诊几率,为子宫内膜异位症的诊断与治疗提供重要参考。     

非编码RNA在子宫内膜异位症中的调控机制及应用的研究进展

子宫内膜异位症是一种良性妇科疾病,影响10%～15%的育龄妇女,其特征是在子宫体以外的部位发现有活性的子宫内膜腺体或间质。然而,由于其发病机制尚未明确,缺乏特异性症状和非侵入性检测方法,常需要外科干预用于诊断和治疗。因此,迫切需要更准确的非侵入性诊断工具和更有效的治疗方式。近年来研究表明,非编码RNA在子宫内膜异位症的发生发展中发挥着极其重要的作用,非编码RNA的异常表达很可能为子宫内膜异位症的早期诊断和病情评估提供理论依据,并为子宫内膜异位症的治疗提供潜在的靶点。现就近年来非编码RNA在子宫内膜异位症中的调控机制及应用的研究进展作一综述。     

腹腔镜诊断子宫内膜异位症并联合药物治疗不孕症157例分析

目的:探讨运用腹腔镜诊断子宫内膜异位症,并观察通过手术联合药物治疗子宫内膜异位症的临床疗效.方法:回顾性分析157例子宫内膜异位症患者腹腔镜手术联合药物治疗后的临床资料.结果:不同期别子宫内膜位异症患者术后联合用药后完全缓解率为84.7%,半年复发率为1.9%,半年妊娠率为59.2%.结论:子宫内膜异位症腹腔镜手术后联合用药可有效降低复发率,提高受孕率.     

改良大鼠子宫内膜异位症模型的建立及微血管密度观察

目的对皮下筋膜层与腹壁肌层之间移植自体子宫内膜制作的子宫内膜异位症（endometriosis,EMs）模型进行评估。方法取10只雌性未交配性成熟大鼠,术前雌激素诱导,手术开腹取右侧子宫,将自体子宫内膜种植于双侧皮下筋膜层与腹壁肌层之间,术后第29天取出异位组织,进行组织形态学观察,免疫组织化学染色观察微血管密度（Microvessel density,MVD）。结果异位内膜在腹壁内生长,呈隆起囊状小包块,内有黏液,具有正常子宫内膜基本组织结构。异位内膜中微血管密度较在位内膜和正常子宫内膜高。结论此手术方法建立的大鼠子宫内膜异位症模型异位内膜病理改变与EMs患者类似,可以作为子宫内膜异位研究的动物模型。     

子宫内膜增生症的治疗现状及研究进展

子宫内膜增生是女性常见的妇科疾病,大多数子宫内膜增生属于良性病变,确诊需进行子宫内膜的组织学病理检查.子宫内膜增生有手术和药物治疗两大方案,选择的方案依据患者的年龄、病理类型及生育需求各有不同.本文就子宫内膜增生的治疗现状以及研究进展进行综述.     

子宫内膜异位症致不孕的病因及治疗研究进展

<正>子宫内膜异位症(EMT)是指子宫内膜组织在宫腔被覆黏膜以外的部位种植生长。子宫内膜具有侵蚀性生长的特点,异位生长粘附性和增殖力均较强,患者常表现为月经紊乱、盆腔疼痛、继发性痛经及不孕等。据流行病学调查显示,35%的不孕症患者患有EMT,而半数以上的子宫内膜异位症患者伴发不孕。Buyalos等[1]在本世纪初首次提出了     

27例卵巢子宫内膜异位症的B超诊断

本文报告经手术及病理证实27例40侧卵巢子宫内膜异位症的声象图表现。分析误诊、漏诊原因。指出B超诊断卵巢子宫内膜异位症的临床价值。     

剖宫产术后腹壁子宫内膜异位症5例探讨

腹壁子宫内膜异位症临床较少见,多发生于中期妊娠剖宫取胎或足月剖宫产术后［１～２］,近年来随着剖宫产率的增加,剖宫产术后腹壁子宫内膜异位症也随之增加。我院１９８４年１月至１９９３年１２月经手术及病理确诊的腹壁子宫内膜异位症５例,现总结报道如下。１临床资...     

Diagnosis of bladder cancer at 465 MHz

Current methods for bladder cancer investigation involve cystoscopy, ultrasound scanning, and contrast urography, with additional information provided by cytology. These methods, although having a high detection rate, are expensive, time-consuming, invasive, and uncomfortable. Therefore, there is a need for an inexpensive, non invasive, quick, and simple investigation with a high sensitivity and specificity. In this study we evaluate the use of an in vivo electromagnetic (EM) interaction as a non invasive method for detecting cancer. A clinical trial was designed and completed. The main trial target was the feasibility assessment of the novel method by comparing its results with standard cystoscopy. A physical discussion of the EM interaction with bladder cancer tissue is presented. One hundred and fourteen patients referred for cystoscopy by microscopic or gross haematuria, irritative voiding symptoms, or suspected bladder tumor at ultrasound were first submitted to EM scan by means of the TRIMprob system. Cystoscopy was performed on each patient after the TRIMprob examination. Comparison between EM and cystoscopy results provides a high level of agreement (Cohen's K = 0.77, p < 0.001). The TRIMprob performance in malignant cancer cells detection suggests that this in vivo EM waves method is also worth investigating for routine diagnostic procedures.     

Endometriosis of the large intestine]

Two cases of large intestine endometriosis are presented. The disease was diagnosed during histological examination of samples taken during surgery. Clinically one case was diagnosed as Crohn's disease, while the second as cancer of the large intestine. The authors suggest, that an extent of surgery for, tumours of the large intestine should be carefully planned, specially if the tissue specimen was not examined histologically earlier.     

Record review of baboons with histologically confirmed endometriosis in a large established colony

Spontaneous endometriosis was diagnosed in 43 baboons over a 14-year period. Thirty-seven have died; five remain alive; one was sold and lost to follow-up. The average age at diagnosis was 17.2 years; 29 (67%) were between 12 and 21 years of age. Fifteen (35%) were diagnosed by biopsy and received surgical excision of the endometriotic tissue; four of these were identified during caesarian section, confirming one prior report of endometriosis in pregnant animals. Twenty-eight (65%) were diagnosed at or shortly preceding necropsy. When diagnosed by a palpable abdominal mass, there was a significantly greater likelihood the animal died or was killed as a result of complications of endometriosis. When diagnosis was at necropsy, there was a significantly greater likelihood that the animal died from causes unrelated to endometriosis. Early identification with surgical removal appears to provide a benefit for both survival and delivering offspring after diagnosis. In twenty-one baboons (49%), endometriosis affected multiple sites within the peritoneal cavity. In the remaining baboons, lesions were more localized. Ovarian involvement was seen in sixteen (37%) of these baboons. This paper is the first to describe significant ovarian involvement in baboons, previously considered a limitation of the usefulness of this species as an animal model. We also describe the first reported endometriosis seeding of an abdominal surgery scar in a baboon. Many of these baboons were middle aged, had few or no offspring, or had evidence of a long duration of uninterrupted menstrual cycles, consistent with risk factors for women. Endometriosis was an incidental finding in 17 (40%) of these baboons, consistent with previous reports of minimal endometriosis as a common asymptomatic finding in baboons and in women. Overall, endometriosis in baboons presents a spontaneously occurring animal model that shares important features with the disease in women and the rhesus macaque.     

The significance of ultrasonography in diagnosing and follow-up of cystic cystitis in children

Cystic cystitis is a separate form of urinary bladder inflammation, detected by cystoscopy in children with recurrent urinary infections. Cystoscopy is an invasive method, so the aim of this investigation was to determine the ultrasonographic characteristics of cystic cystitis and to assess the reliability of ultrasound in relation to cystoscopy in diagnosing cystic cystitis. The study included 115 girls with repeated urinary infections. Cystoscopy and ultrasonography was performed in all. According to the cystoscopic finding the subjects were divided into 4 groups. Lateral and posterior urinary bladder wall thickness was measured during ultrasonography. A statistically significant difference was found between all 4 groups, the method demonstrated a high degree of sensitivity (0.97) and specificity (0.91). Percentile calculations were determined for wall thickness. Ultrasonography can replace endoscopy in diagnosis and follow-up of cystic cystitis in children, with at least 50% fullness of the urinary bladder as a prerequisite.     

A Case of Vesical and Scrotal Sparganosis Presenting as a Scrotal Mass

A 59-year-old Korean man complained of a painless scrotal hard nodule and weak urine stream. The ultrasound scan revealed a 2.2-cm sized round heteroechogenic nodule located in the extratesticular area. Microscopic hematuria was detected in routine laboratory examinations. On scrotal exploration, multiple spargana were incidentally found in the mass and along the left spermatic cord. On cystoscopy, a 10-mm sized mucosal elevation was found in the right side of the bladder dome. After transurethral resection of the covered mucosa, larval tapeworms were removed from inside of the nodule by forceps. Plerocercoids of Spirometra erinacei was confirmed morphologically and also by PCR-sequencing analysis from the extracted tissue of the urinary bladder. So far as the literature is concerned, this is the first worm (PCR)-proven case of sparganosis in the urinary bladder.     

Plasmacytoma with involvement of the urinary bladder. Report of a case diagnosed by urine cytology

BACKGROUND: Plasmacytoma of the bladder is a rare but important entity. We report a case of plasmacytoma of the bladder that was diagnosed by urinary cytology. CASE: A 71-year-old male with a history of multiple myeloma presented in renal failure. Renal ultrasound revealed right-sided, moderate hydronephrosis with a 4 x 4-cm, posterolateral, obstructing mass. Magnetic resonance imaging demonstrated a bladder mass involving the bladder base, right lateral wall and dome with extension into the perivesical tissues on the right. The mass showed a moderate degree of enhancement following intravenous gadolinium administration. Urine cytology was performed to evaluate for bladder carcinoma or other malignancies besides plasmacytoma. The specimen was signed out as multiple myeloma of the bladder. Cystoscopy and biopsy were subsequently performed on the bladder mass. The diagnosis of plasmocytoma was made, confirming the urine cytology diagnosis. CONCLUSION: Urinary cytology can be a diagnostic tool for plasmocytoma involving the bladder.     

Pregnancy outcome of 30 fetuses with cystic hygroma diagnosed during the first 15 weeks of gestation

The goal of the study was to assess the prognostic value of ultrasound finding of fetal cystic hygromas. Thirty cases of septated cystic hygromas were diagnosed at 10-15 weeks gestation by transabdominal ultrasound and followed through pregnancy. The rate of abnormal karyotype was found to be 61% and the global rate of unfavorable outcome, independently of karyotype result, as high as 96%. These data suggest that cautious genetic counselling should be offered when such cystic hygromas are noticed during the first 15 weeks of gestation, even with a normal karyotype.     

Fine needle cytology of endometriosis: experience with 10 cases

OBJECTIVE: To evaluate whether commonly used cytologic criteria for the diagnosis of endometriosis are sufficiently specific, to assess the possible role of special methods in the differential diagnosis and to assess the clinical meaning and drawbacks of a cytopathologic diagnosis of endometriosis by fine needle aspiration. STUDY DESIGN: We retrieved 10 cases of endometriosis from our files that had been diagnosed primarily by fine needle cytology (FNC) with subsequent tissue study. In some cases additional cytospin preparations and/or smears had been used for cytochemistry (periodic acid-Schiff stain, mucicarmine) or immunocytochemistry (pan-cytokeratin, cytokeratin 7, vimentin, CD10) using a 3-step streptavidin-biotin-immunoperoxidase reaction. RESULTS: The cell pattern and immunocytochemical profile of the cases suggested a diagnosis of endometriosis. All cases were histologically confirmed. CONCLUSION: With optimal preparations a confident cytologic diagnosis of endometriosis may be made with ease, permitting correct treatment of the disease and, in selected cases, planning of preoperative pharmacologic therapy.