女子尿道憩室により尿閉を生じた1例

Abstract

49歳女性。患者は尿閉を主訴にとした。外尿道口周囲および腟前壁に弾性硬な膨隆が認められ, 超音波ガイド下に病変部を穿刺し, 症状は一時的に軽快したが約1ヵ月後に再度排尿困難が出現した。精査・加療目的に著者らの施設へ入院となったが, 経腟的超音波, MRIにて尿道周囲に嚢胞性病変が確認され, 内視鏡下に腟前壁よりインジゴカルミンを注入し尿道内を観察したところ, 尿道憩室が認められた。憩室摘除術を行った結果, 病理組織学的に悪性所見はみられず, 術後に自然排尿可能となった。術後2ヵ月経過現在, 排尿困難感は消失し, 残尿も著明に改善した。

We report a 49-year-old female who had circumferential urethral diverticulum. She was admitted to our department for urinary retention. A cystic lesion surrounding the urethra had been detected by magnetic resonance imaging. We diagnosed the lesion as a urethral diverticulum after injecting dye to the cystic mass from vagina and confirming its discharge from the urethra at the pubic side by urethroscopy. Transvaginal resection of the diverticulum was peformed. In general, 4% of female urethral diverticula cause urinary retention. On the other hand, 1% of female bladder outlet obstruction is caused by urethral diverticula. It is neccessary for us to keep in mind urethral diverticulum when we evaluate female patients with urinary retention.