女性尿道和尿道周围肿块的评估和管理。
Evaluation and management of urethral and periurethral masses in women.
发表日期:2023 Aug 30
作者:
Stephanie W Zuo, Gnankang Sarah Napoe
来源:
PHYSICAL THERAPY & REHABILITATION JOURNAL
摘要:
女性尿道周围肿块出现是较为罕见的。本综述的目的是描述女性尿道和尿道周围肿块的病因,并提供关于诊断和治疗的最新进展。女性尿道和尿道周围肿块最常见的原因是尿道乳头瘤、尿道憩室和斯恩氏腺囊肿。例如,尿道乳头瘤和脱垂等尿道口病变可以通过局部雌激素治疗和密切随访以保守方式进行管理,或应在血栓形成、明显或反复出血、急性尿潴留或持续疼痛的情况下行切除。斯恩氏腺囊肿等良性尿道周围腺体肿块仍然很少见。最近的病例系列显示,对这些肿块的手术治疗率较高,且并发症较少。尿道恶性肿瘤或良性病因的恶性转化更为罕见,但可能具有侵袭性,应及时治疗。非特异性的尿液和阴道症状以及类似的身体表现使女性尿道和尿道周围肿块的诊断困难。磁共振成像对于区分尿道周围肿块非常有用。保守或手术治疗的决定通常由患者症状的困扰程度以及对尿道恶性肿瘤的担忧来指导。版权所有 © 2023 Wolters Kluwer Health,Inc. 保留所有权利。
Female periurethral masses are an uncommon occurrence. The purpose of this review is to describe etiologies of female urethral and periurethral masses and to provide an update on diagnosis and management.The most common causes of periurethral and urethral masses in women are urethral caruncles, urethral diverticula, and Skene's gland cysts. Urethral meatal lesions such as urethral caruncles and prolapse can be managed conservatively with topical estrogen therapy and close follow-up or should be excised in the setting of thrombosis, significant or recurrent bleeding, acute urinary retention, or persistent pain. Benign periurethral gland masses, such as Skene's gland cysts, Gartner's duct cysts, and Mullerian duct cysts, remain rare. Recent case series reveal a high rate of surgical management of these lesions with few complications. Urethral malignancy or malignant transformation of benign etiologies are even rarer but can be aggressive in nature and should be treated promptly.Nonspecific urinary and vaginal symptoms as well as similar physical presentations make diagnosis of urethral and periurethral lesions in females difficult. Magnetic resonance imaging is useful for differentiation of periurethral masses. The decision for conservative or surgical management is typically guided by patient symptom bother, as well as concern for urethral malignancy.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.