前立腺部尿道の前立腺上皮性ポリープ25例の臨床的検討

Abstract

前立腺部尿道の前立腺上皮性ポリープ(PP)25症例を対象に, 肉眼的血尿を中心とした症状及び内視鏡所見を分析し検討した.肉眼的血尿が一番多く64%, 血精液症が32%に認められ, 血性尿道分泌物は24%と比較的高頻度に認められた.PPは前立腺部尿道のポリープ性病変でありながら, 肉眼的血尿症例の44%が全血尿のタイプであった.血精液症8例全例で精液が赤色であり, 血尿を合併する血精液症の場合はPPが原因である可能性が大きいので, 診断のため尿道膀胱鏡検査が推奨される.再発の頻度は5%であった.原因疾患の鑑別のため内視鏡検査を行う場合には, PPの存在を念頭に置き, 前立腺部尿道, 特に精丘とその近傍を注意深く観察するべきである

To clarify the clinical manifestations of prostatic-type polyps (PP) in the prostatic urethra, a sample of 25 patients with PP who presented themselves to our hospital with hematuria or hematospermia was reviewed with respect to their symptoms and endoscopic findings. Recurrence of the conditions was also investigated. The patients were 26 to 68 years old, with a mean age of 48.5 years. Sixteen patients (64%) had hematuria and 8 (32%) had hematospermia. A bloody urethral discharge was observed in 6 patients (24%). Analysis of the character of the hematuria showed that total hematuria occurred in 44% of the patients. In 38% of the patients with hematospermia there was the additional symptom of post-ejaculatory hematuria. PP developed beside the verumontanum in 18 patients (72%), on the posterior urethral wall lateral to the verumontanum in 4 patients (16%), and on the verumontanum in 7 patients (28%). The prognosis could be investigated only in 22 (88%) of the 25 patients. Two patients (9%) experienced reccurrence during the follow-up period (1 to 5.8 years, mean: 3.7 years). Consequently, special attention should be paid to the possibility of PP in the prostatic urethra, particularly the verumontanum and nearby area, during endoscopic examination, when diagnosing patients with hematuria, hematospermia or with bloody urethral discharge.