膀胱全摘除術後の尿路再建 - 尿道より排尿可能なKock式回腸膀胱 -

Abstract

回腸膀胱では残尿が50 ml以下ならば間欠的導尿を行わないで経過をみているが, 長時間経過した場合, reservoirの過伸展による腸管壁の変化, およびそれにともなうreservoir容量の変化が, 今後の問題点となりうる

From September 1989 to March 1990, 6 male patients with invasive bladder cancer, 49 to 70 years old in age, underwent bladder replacement with the ileum (the urethral Kock pouch) after radical cystectomy. Follow up ranged between 3 and 9 months. Urodynamic evaluation showed the ileal bladder to be a low pressure reservoir with a capacity that increased to more than 250 ml. The ileal bladder was emptied by straining without significant residual urine in all patients except one who was performing intermittent self-catheterization. All patients were continent in the daytime. However, all patients required pads at night because of occasional loss of a little urine. Excretory urograms revealed excellent upper tract function. The procedure is suitable whenever the urethra can be preserved after cystectomy for cancer.