精巣上体炎を繰り返したWebbed penis without chordeeの1例

Abstract

11歳男.左陰嚢部腫瘤, 外陰部奇形を主訴とした.9歳時より左精巣上体炎を反復しており, 初診時, 左精巣上体尾部に小豆大の硬結を触知した.また, 陰茎腹側の皮膚と陰嚢が融合し陰茎を持ち上げるとその間の皮膚が水かき状を呈したが, 真性包茎以外の尿路奇形や検尿の異常所見はみられなかった.左精巣上体炎, 包茎および翼状陰茎(webbed penis without chordee)と診断して包茎とwebbed penis without chordeeについては手術を予定し, 左精巣上体炎はミノサイクリン投与にて改善した.翼状陰茎修復術と包茎に対する背面切開術を施行し, 術後9ヵ月にて精巣上体炎の再発は認めず, 包皮の影響を受けることなく排尿が可能となった.自験例の再発性精巣上体炎は包皮部の排尿時抵抗増加による尿道精管逆流が原因と考えられ, 他の合併症のないwebbed penis without chordeeであっても早期に手術を行う必要があると考えられた

An 11-year-old boy visited our clinic complaining of recurrent epididymitis for 2 years. No abnormal findings were found in urine and blood sampling tests, ultrasonography of the urinary tracts or in a pelvic magnetic resonance imaging examination. Induration of the left epididymal tail, webbed penis and true phimosis were observed. Neither hypospadias nor chordee were identified, thus the diagnosis of "webbed penis without chordee" was made. The operation for webbed penis by transverse incision followed by longitudinal suture and dorsal incision for true phimosis was performed successfully. The postoperative course was uneventful and no recurrence of epididymitis has occurred.