congenital posterior urethral fistula
Introduction
Introduction to congenital posterior urethra Urethral fistula (urethralfistula) refers to a pathological state in which some or all of the urine is excreted through the abnormal passage of the urethra or flows through other organs and excreted from the body. According to the cause of the disease, it can be divided into congenital and acquired. Congenital urethral fistula is rare, divided into anterior urethral fistula and posterior urethra fistula, anterior urethra fistula is extremely rare, posterior urethra fistula is more than anterior urethra fistula, often complicated with rectal anal canal malformation. basic knowledge Sickness ratio: 0.05% Susceptible population: newborn Mode of infection: non-infectious complication:
Cause
Congenital posterior urethral fistula
(1) Causes of the disease
During embryonic development, urinary genital folds are not closed or the urogenital sinus is separated from the rectum, causing the urethra to communicate with the rectum or perineum, which can be divided into the following three types.
1. Urethral rectal fistula complicated by anorectal atresia The end of the rectum becomes thinner, leading to the posterior urethra, some communicating with the urethra of the prostate (Fig. 1A), some communicating with the urethra of the membrane (Fig. 1B), without anus, meconium from the urethra Excretion, combined with congenital urethral stricture, is the most common type of clinical.
2. "H" shaped urethra rectal fistula anorectal normal, there is a fistula between the posterior urethra and the rectum, showing an "H" shape (Figure 1C).
3. The posterior urethra perineal fistula starts in the posterior urethra and communicates with the perineal skin.
(two) pathogenesis
Currently no relevant information
Prevention
Congenital posterior urethral fistula prevention
There are no effective preventive measures.
Complication
Congenital posterior urethral fistula complications Complication
There is currently no relevant information.
Symptom
Congenital posterior urethral fistula symptoms Common symptoms Urine turbidity complex urinary tract infection urethra sputum urinary tract urinary sinus intestinal atresia
Neonatal anorectal atresia, urinary tract venting when urinating, urine turbidity, mixed with fetus, can be diagnosed, "H" shaped urethral rectal removal can have the above symptoms, but also the urethra does not urinate, urine is discharged from the rectum, presented Watery stool, due to urine into the rectum through the fistula, can occur high blood chlorine acidosis, most patients with pyelonephritis, repeated attacks, perineal sputum, mainly urinary leakage of the perineum, general fistula small, urine flow Not in the line, in the form of drops, carefully observed to see the mouth, some in the genital genital saclike bulging, the top has a small hole leaking urine, sick children may have lower urinary tract infection, if not concurrent urinary tract Malformation and vesicoureteral reflux are not harmful.
Examine
Congenital examination of posterior urethral fistula
Urinary bladder urethra angiography, the contrast agent can be seen into the rectum, the large pupil can be determined by the endoscope, the small pupil endoscope is not easy to see, the "H" shaped fistula can be seen through the proctoscope The hole or the pupil is sunken, and the urine is blue after the rectal methylene blue enema.
Diagnosis
Diagnosis and diagnosis of congenital posterior urethra
Neonatal anal atresia should be thought of the possibility of urethral rectal fistula. The anus can be diagnosed in the anterior rectal wall of the rectum 1 to 2 cm away from the anus. The urethra angiography and endoscopy can be used to confirm the diagnosis.
