膀胱Endometriosisの1症例

Abstract

Endometriosis (Sampson, 1921) is the endometrium or the tissue originated from it, which including the isolated glands and the surrounding stroma of endometrial type, and grow and multiply beyond the uterine cavity. This tissue behaves in quite the same manner as the endometrium periodically according to the menstrual cycles. Some ectopic locations of this tissue are seen in ovaries, uterine ligaments (round, uterosacral), rectovaginal septum, pelvic peritoneum containing the uterus, tubes, rectum, sigmoid or bladder, umbillicus, scars after laparotomy, hernial sacs, appendix, vagina, vulva, cervix, tubal stumps, lymph gland, perineum, inguinal area, lung, etc. This dis e a se is observed mainly in the female genital organs. The existance of the disease in the urological organs is generally rare, although its frequency in the urinary bladder is commonly known. Judd ( 1 921) reported a case that was first recognized cystoscopically and that made a favorable turn after resection of the tumor. He suggested in his report that there might have been a complicated lesion in the upper urinary tract. Subsequently Kretschemer (1945), Beecham and McCrea (1957), Abeshouse and Abeshouse (1960) have made critical review of endometriosis in the field of urology on the clinical and pathological points of view. Our case, Who was a 39 years old female and para 2, v isited us with complaints of vesical symptoms (burning on urination, low abdominal pains) before and after the menses during the past one year. On urological examination, some scattered hemispheric cysts about the size of peas were demonstrated in the region of the trigone, among which were recognized several chocolate cysts, and a diagnosis of vesical endometriosis was made. After hysterooophorectomy and partial cystectomy, the vesical symptoms disappeared. The histological examination revealed the picture of endometriosis alone in the bladder. Based on our case, discussions were made mainly on defini t i on, pathogenesis, frequency of vesical endometriosis age, problems of whether primary or secondary, urological complications, clinical examinations of endometriosis in our country, and histological review of this differentiation between this disease and stromal endometriosis, and its malignant changes.