本文报道一例肾盂并膀胱绒毛状腺瘤病例。患者因“全程肉眼血尿、尿频、尿急、排尿困难半月”入院。外院CT显示右肾和膀胱肿物，考虑恶性病变，右肾积水及双肾结石。患者长期结石、感染，血肌酐159 μmol/L。考虑先行经尿道膀胱肿瘤电切术明确肿物性质，但因膀胱内尿液黏稠，未能完全切除肿瘤，病理诊断为膀胱绒毛状腺瘤。考虑膀胱病变为良性，遂优先处理右肾肿瘤。1 个月后行机器人辅助腹腔镜右肾盂癌根治术，病理显示肾盂-肾盏绒毛状腺瘤伴高级别上皮内瘤变。术后出现尿管堵塞，拔管后排尿不畅，血肌酐波动至180～200 μmol/L。经广东省医学会泌尿外科疑难病例多学科会诊，专家建议膀胱部分切除术，暂不考虑放疗或化疗。2 个月后行膀胱部分切除术，术后黏液尿减少，尿路感染好转，血肌酐169 μmol/L。该病例表明，泌尿系绒毛状腺瘤通过手术切除可有效治疗。

This article reports a case of renal pelvis and bladder villous adenoma.The patient was admitted with a history of gross hematuria，urinary frequency，urgency，and dysuria for half a month.CT imaging from an external hospital revealed masses in the right kidney and bladder，suspected to be malignant，along with right renal hydronephrosis and bilateral kidney stones.The patient had a long history of stones and infections，with a serum creatinine level of 159 μmol/L.Initial management involved transurethral resection of the bladder tumor to identify the nature of the tumor，but due to viscous urine，the tumor could not be fully excised，and the pathology diagnosis was bladder villous adenoma.Given that the bladder lesion was benign，priority was given to addressing the right kidney tumor.One month later，the patient underwent robot-assisted laparoscopic right nephrectomy for renal pelvis cancer，and pathology revealed renal pelvis and calyx villous adenoma with high-grade intraepithelial neoplasia.Postoperatively，the patient developed urethral catheter obstruction，and after catheter removal，experienced persistent dysuria，with serum creatinine fluctuating between 180-200 μmol/L.The multidisciplinary consultation by the Guangdong Urological Association led to a recommendation for partial cystectomy，with no immediate plans for radiotherapy or chemotherapy.Two months later，the patient underwent partial cystectomy，with a subsequent reduction in mucus-like urine，improved urinary tract infections，and a serum creatinine level of 169 μmol/L.This case suggests that surgical resection is an effective treatment for urinary tract villous adenomas.