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Mündung eines Megaureters mit aplastischer Niere in eine Samenblasenzyste

Fallbericht einer laparoskopischen Intervention

  • Kasuistik
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Zusammenfassung

Unilaterale Samenblasenzyste, ipsilaterale Ureterektopie und ipsilaterale Nierenaplasie sind die Komponenten eines seltenen Missbildungskomplexes des männlichen Urogenitaltraktes. Klinisch im Vordergrund steht eine retrovesikale zystische Raumforderung im kleinen Becken, die unspezifische Symptome verursachen kann. Die Differentialdiagnose umfasst u. a. Zysten des Müller-Ganges, des Sinus urogenitales bzw. des Ductus ejaculatorius und der Prostata.

Es wird der Fall eines 14-jährigen Jungen mit zystischer linker Samenblase dargestellt. Präoperativ bestand der Verdacht auf eine ipsilaterale Nierenagenesie, jedoch stellte sich intraoperativ eine Nierenaplasie mit ektoper Harnleitermündung in die Samenblase dar. Die 8 cm große Samenblase und die ipsilaterale aplastische Niere konnten erfolgreich durch einen laparoskopischen Eingriff entfernt werden.

Vorteile des laparoskopischen Vorgehens im Vergleich mit der offen-chirurgischen Technik sind in der besseren Darstellung der intrapelvinen Strukturen, dem kurzen Krankenhausaufenthalt und in der schnellen Rekonvaleszenz des Patienten zu sehen. Anhand der Literatur wird auf Klinik, Diagnostik, Differentialdiagnose und therapeutisches Vorgehen dieser Anomalie eingegangen.

Abstract

Unilateral cyst of the seminal vesicle, ipsilateral ectopic ureter, and ipsilateral renal aplasia are the components of a rare congenital abnormality affecting the male urogenital tract. The clinical picture is characterized by a retrovesical cystic tumor, which may cause nonspecific symptoms. Differential diagnosis includes cysts of the müllerian duct, the urogenital sinus/ejaculatory duct, and the prostate.

We report a case of a left seminal vesicle cyst associated with aplasia of the left kidney in a 14-year-old boy. Preoperatively, an ipsilateral renal agenesis was suspected, but a renal aplasia with an ectopic urinary megaureter into the seminal vesicle was found intraoperatively. An 8-cm cystic left seminal vesicle and an ipsilateral renal aplasia was successfully removed by operative laparoscopy.

The advantages of the laparoscopic approach over open surgery include excellent exposure of the deep pelvic structures, a short hospitalization, and a rapid recovery for the patient. We searched the literature to review the clinical presentation, diagnostic procedures, differential diagnosis, and therapeutic treatment options for this anomaly.

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Authors and Affiliations

  1. Urologische Klinik, Carl-Thiem-Klinikum, Cottbus

    B. Hoschke, M. May, M. Seehafer & C. Helke

  2. Urologische Klinik, Carl-Thiem-Klinikum, Lehrkrankenhaus der Universitätsklinik Charité zu Berlin, Thiemstraße 111, 03048, Cottbus

    B. Hoschke

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  1. B. Hoschke
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  2. M. May
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  3. M. Seehafer
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  4. C. Helke
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Correspondence to B. Hoschke.

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Hoschke, B., May, M., Seehafer, M. et al. Mündung eines Megaureters mit aplastischer Niere in eine Samenblasenzyste. Urologe [A] 42, 1092–1096 (2003). https://doi.org/10.1007/s00120-003-0336-1

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