特異な臨床経過を示した尿道損傷の1例

Abstract

22歳男.本症例は尿道球部が落下時の打撲により損傷されて尿道に裂傷を形成し, その裂傷を通じて尿道と挫滅して血腫を生じた部位が交通し, 排尿時の圧力によって憩室様変化をきたしたものと思われる.著者等が検索しえたかぎりでは本邦において, 会陰部打撲後同様に尿道に憩室様変化を示した症例は他に報告されていない.経会陰的に裂孔閉鎖術を行い治癒できた

A 20-year-old men fell from a ladder in 1995, striking his perineum strongly, and macroscopic hematuria with painful urination lasted for several days. Subsequently, swelling of the perineum on urination continued to occur. However, he did not seek medical treatment until July 1997, when he consulted our medical institution. A diverticulum-like change was found in the bulbous urethra on urethrocystography, and a tear in the same position on urethroscopy. On September 22, 1997, surgery was performed after constructing a cystostomy, the tear was located using a urethroscope, and closed through a perineal approach. At 14 days after surgery, there was extra-urethral leakage of contrast media on voiding cystourethrography, and at 28 days after surgery, the findings showed improvement. Since then, he has been free of the preoperative symptoms.