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患者,女,23岁,农民。从12岁开始下腹胀满,小便淋沥,经常腹痛,有时随小便排出似花生米大小腐肉样物。婚后出现膀胱刺激症状,并从尿道脱出拳头大小的葡萄状灰白色颗粒样肿物,偶有出血,小便失禁。拟诊为“膀胱乳头状瘤”收治入院。体检:面色蜡黄,血压12.8/9.33kPa。耻骨上区隆起,尿道外口可见肿瘤露出部分比拳头大,表面呈灰白色颗粒样。尿道极度扩大可容纳4指,尿道、腹壁双合诊可扪及膀胱区有儿头大之肿物,质稍硬,有触痛,边界清晰,可移动。直肠及阴道内未发现肿物。实验室检查:血:Hb8.5g/dl,WBC 10 000/mm~3。尿:蛋白(++++)、RBC(+++)、WBC 0～4/HP。胸片阴性。IVP示:双肾有不同程度的肾盂积水和输尿管扩张改变,膀胱显示圆形不规则的充盈缺损区,膀胱镜检见整个
Patient, female, 23 years old, farmer. Abdominal distension from the age of 12 full, leaching leaching urine, often abdominal pain, sometimes with the pee-like carcass-like size of carrion-like material. Bladder irritation occurs after marriage, and fist-sized grainy grayish white granuliform mass from the urethra occasionally bleeding, urinary incontinence. To be diagnosed as “bladder papilloma” admitted to hospital. Physical examination: looking waxy, blood pressure 12.8 / 9.33kPa. Suprapubic area uplift, visible urethral tumor outcrops larger than the fist, the surface was gray particles. Urethra can be enlarged to accommodate 4 refers to the urethra, abdominal double diagnosis of palpable bladder area with a big head of the tumor, the quality of hard, tenderness, the boundary is clear and can be moved. No rectal and vaginal mass was found. Laboratory tests: blood: Hb8.5g / dl, WBC 10 000 / mm ~ 3. Urine: Protein (++++), RBC (+++), WBC 0-4 / HP. Chest negative. IVP shows: the kidneys have varying degrees of hydronephrosis and ureteral dilatation changes, bladder irregular filling filling defect area, cystoscopy see the whole