同側腎無形成を伴った精嚢嚢胞の1例

Abstract

26歳男.上腹部不快感にて近医受診し, 胃内視鏡にて慢性胃炎と診断され, 膀胱背側に嚢胞状の病変と左腎無形性が疑われ当科紹介された.精路との交通を調べる為, 両側精管精嚢造影を施行した.画像上, 左腎無形性, 左尿管精嚢異所開口と診断された.治療方針について苦慮したが, 元来無症状であるため経過観察することとなった.現在5ヵ月経過するも無症状でありTRUS(Transrectal ultrasonography)にても嚢胞の再発は認めていない

A 26-year-old man was referred to our hospital for further evaluation of a cystic lesion in the pelvis. He was completely asymptomatic, although he experienced gross hematuria 10 months before his visit. Drip infusion pyelography (DIP) and abdominal computerized tomography (CT) showed a cystic structure behind the bladder and absence of the left kidney. Transrectal ultrasonography (TRUS) suggested left ejaculatory duct obstruction and seminal vesicle deformity. On cystoscopy a large bulging mass under the left side of the bladder was seen. The left half of the trigone and left ureteral orifice were absent. Vasovesiculography demonstrated dilated and tortuous left seminal vesicle. Three days after this procedure, the patient suffered left epididymitis. It did not respond rapidly to antibiotic therapy, so percutaneous drainage of the cyst was performed. He has been completely free of symptoms and no seminal vesicle cysts have been detected on TRUS at five months follow-up.