| Objective: According to statistics, that is, the inconsistent attendance rates of the first clinical diagnosis and the final diagnosis of duplex kidney, the author aims to analyze its causes. Through viewing the accuracy of a variety of diagnosis, we can further explore ways to improve the accuracy of earlier diagnosis of duplex kidney so that the patients can receive comprehensive treatment.Materials and methods: Collecting the clinical data of 46 patients with duplex kidney treated in the Provincial Hospital from November, 1993 to March, 2009. (Excluding pediatric urology patients), we can do studies retrospectively. The author collects statistics of patients with gender, age, clinical symptoms, surgical approach and types of duplex kidney. Other imaging data like type-B ultrasonic, CT, IVU, cystoscopy +RP and MRU are also collected. And then, the author sums up the check for the duplex kidney and analyze the advantages and disadvantages of each type of diagnosis. And the clinical statistics of the patients that are not clearly found out is also collected. The author tries to analyze the reasons.Results: In the collection of the 46 cases of duplex kidney, patients of 32 cases(69.6%) have the symptoms of abdominal pain; 10 patients (21.7%) have thesymptoms of urinary stimulation; 6 patients (13.0%) have recurrent fever; 7 cases(10.9%) have continuity with normal urinary leak; 7cases (15.2%) are withoutobvious symptoms. Among the 46 cases, 47.8% are checked by the first time withtype-B ultrasonic. The final diagnosis rate is 67.4%. Among the 36 cases with CT, the final rate of diagnosis is 86.1%. And the 31 cases with IVU, the rate is 71.0%. 34 cases are with cystoscopy +RP. We consider the finding of double-cystoscopy, retrograde ureteral orifice showing two or Y-shaped utreter as the diagnosis of duplex kidney. Clear diagnosis rate is 47.1%. 31 cases are at the same time with type-B ultrasonic and IVU, and the diagnosis rate is 90.3%. 8 cases are with MRU examination, all of which are found duplex kidney. All show clear existence of expansion of water throughout ureter duplication and the position of ectopic ureteral opening can be tracked.Conclusion: As the most common disease in the field of urinary, the misdiagnosis rate is pretty high. The most common misdiagnosis are renal crsts, urinary tract infection and so on. The symptoms of duplex kidney are mostly seen in the pain of the waist. And then the leak and repeated urinary tract infection of long term. When seeing the appearance of the above symptoms, we should think about the possibility of duplex kidney. As for the diagnosis of duplex kidney, type-B ultrasonic can be used as the first choice, but it is with the highest rate of misdiagnosis. MRU examination is with the highest rate of diagnosis, and it can find out the position of ectopic ureteral orifice. IVU can be combined with type-B ultrasonic examination, which can make sure of higher rate of diagnosis. CT can create pretty high rate of diagnosis and it can also provide the program of the operation and is the basis for the choice of incision. RP examination is of critical importance to the clarity of the causes and position of expansion of water throughout ureter duplication. If we want to obtain the exact examination of duplex kidney, it is needed to consider the clinical symptoms, to combine several means of diagnosis, and finally, we can make comprehensive judgments. |
