出生前診断される腎尿路奇形

Abstract

1)出生前に発見された疾患は, 腎盂尿管移行部狭窄19例, 多嚢腎12例, 巨大尿管6例, 尿管瘤4例など計56例であった.2)異常を指摘された時期は, 妊娠20週以前が2例, 20週～29週が14例, 30週以降が40例であった.3)新生児期に処理を行った症例は13例で, 尿道留置カテーテル・膀胱皮膚瘻・尿管皮膚瘻, TUR-celeなどを行っていた.4)外科的治療を行った症例は25例, 経過観察している症例は24例, 死亡は7例であった

Advances and spread in ultrasonography in obstetrics have resulted in the increase in the number of reports of congenital anatomical anomalies that have been diagnosed prenatally. We present 56 patients with congenital urinary tract anomalies, which were found by prenatal USG. These anomalies included pelvi-ureteric junction stenosis in 19, multicystic kidney in 12, primary megaureter in 6, ureterocele in 4, posterior urethral valve in 3, polycystic kidney in 2, vesicoureteral reflux in 2, urogenital sinus anomaly in 2 and others in 4. There were 9 oligohydramnios: posterior urethral valve in 2, polycystic kidney in 2, bilateral multicystic kidney in 2, urogenital sinus anomaly in 2 and vesicoureteral reflux in 1. In the neonatal period, urological treatment was performed on 13 patients; indwelling catheter on 4, vesicostomy on 2, ureterocutaneostomy on 2, TUR cele on 2 and others on 3. Among the cases, 25 have been operated on after the various intervals of follow-up periods. Pyeloplasty was performed on 9 patients with pelvi-ureteric junction stenosis, total reconstriction on 4 with ureterocele, ureterocystoneostomy on 3 with megaureter and others on 9. There were 7 lethal cases; polycystic kidney in 2, multicystic kidney in 2, posterior urethral valve in 1, megaureter in 1 and urogenital sinus anomaly in 1. It seems likely that various kinds and increasing number of urinary tract abnormalities will be diagnosed through prenatal USG. It is now important to make a consensus for the timing and management of the therapy of these anomalies.