上部尿路外溢流現象の臨床的検討 : 自験例5例の報告ならびに臨床的および文献的考察

Abstract

We studied the etiology, diagnosis and management of 201 cases of urinary extravasation reported in the Japanese literature along with our five cases. Most of them were caused by urolithiasis and malignant tumors. Four of our five cases also presented with a ureter stone; two being cured by spontaneous stone passage within several days and the others being treated by ureterolithotomy or nephrectomy. The other case involving a ureter tumor was treated by nephroureterectomy with partial cystectomy. The clinical manifestations of urinary extravasation were distinguished as spontaneous peripelvic extravasation and spontaneous rupture of the renal pelvis and ureter. Performing an accurate and differential diagnosis of these cases, however, was difficult. We therefore propose a set of clinical diagnostic criteria based on our findings of X-ray examination and the macroscopic appearance seen during surgical treatment. We review the 201 reported cases along with our five cases of urinary extravasation and discuss their diagnostic procedures and treatment approaches.