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Ureterektopie mit Harnträufeln im Kindesalter — eine diagnostische Herausforderung

Eigene Erfahrungen und Literaturübersicht

Ectopic ureter with urinary dribbling in childhood — a diagnostic challenge

Our own experience and review of the literature

  • Freies Thema
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Zusammenfassung

Anhand der Kasuistiken von 4 Mädchen mit Harnträufeln wurden die Besonderheiten und Schwierigkeiten bei der Diagnostik von ektop mündenden Harnleitern untersucht. Bei allen Patientinnen war die Diagnostik deutlich verzögert, in einem Fall wurde die Anomalie sogar erst im Alter von 18 Jahren entdeckt. Bei der Verschleppung der Diagnosefindung spielte die Fehleinschätzung der Beschwerdesymptomatik eine wichtige Rolle. Auch der Nachweis dieser Anomalie stellt eine diagnostische Herausforderung dar. Die ektopen Ureteren waren mit dysplastischen, funktionseingeschränkten Nierenanlagen assoziiert. Die zur Abklärung initial häufig eingesetzten diagnostischen Verfahren wie Sonographie, Ausscheidungsurographie (AUG) oder Miktionszystourethrographie (MCU) lieferten inkomplette diagnostische Informationen oder konnten die Verdachtsdiagnose nicht sichern. Erst mit der MR-Urographie konnte die Diagnose präoperativ zuverlässig geklärt werden. Die Ergebnisse der verschiedenen Untersuchungsmodalitäten wurden analysiert und ihre diagnostische Aussagekraft in Zusammenschau mit den Ergebnissen aus der Literaturübersicht diskutiert.

Abstract

Based on the observations in four girls suffering from constant urinary dribbling we analyzed the special features and difficulties in making the diagnosis of an ectopic ureter. In all patients there was marked diagnostic delay. In one symptomatic case the abnormality was not detected before the age of 18 years. Failure to recognize the characteristic signs and symptoms played a crucial role in delaying the diagnosis. Moreover, imaging of ureteral ectopia represents a diagnostic challenge. The ectopic ureters were associated with dysplastic, poorly functioning renal moieties. Common diagnostic imaging procedures, such as ultrasound, intravenous pyelography, or voiding cystourethrography yielded incomplete diagnostic information and often failed to provide a definitive diagnosis. The latter could only be obtained with MR urography. We assessed the diagnostic value of the different examinations and compared our findings with those reported in the literature.

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Authors and Affiliations

  1. Abteilung für Pädiatrische Radiologie des Instituts für Röntgendiagnostik, Klinikum der Julius-Maximilians-Universität Würzburg

    A. Heidemeier &  K. Darge

  2. Abteilung Pädiatrische Nephrologie der Kinderklinik und Poliklinik, Klinikum der Julius-Maximilians-Universität Würzburg

    A. Kirchhoff-Moradpour

  3. Urologische Klinik und Poliklinik, Klinikum der Julius-Maximilians-Universität Würzburg

    H. Riedmiller

  4. Klinik für Radiologische Diagnostik, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen

    G. Staatz

  5. Abteilung für Pädiatrische Radiologie des Instituts für Röntgendiagnostik, Universitätsklinikum, Josef-Schneider-Str. 2/D31, 97080 , Würzburg

    K. Darge

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  1. A. Heidemeier
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  2. A. Kirchhoff-Moradpour
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  3. G. Staatz
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  4. H. Riedmiller
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  5. K. Darge
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Correspondence to K. Darge.

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Heidemeier, A., Kirchhoff-Moradpour, A., Staatz, G. et al. Ureterektopie mit Harnträufeln im Kindesalter — eine diagnostische Herausforderung. Radiologe 47, 411–420 (2007). https://doi.org/10.1007/s00117-005-1330-y

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  • DOI: https://doi.org/10.1007/s00117-005-1330-y

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