萎縮膀胱に対するreplacementileocystoplastyの1例

Abstract

The patient was a 49-year-old male. He had a history of asymptomatic hematuria that had occurred 3 years previously. The hematuria and pollakisuria developed again from about March, 1989, and he was hospitalized for bladder tamponade in April. Bilateral percutaneous nephrostomies were performed because a contracted bladder and bilateral hydronephrosis were detected. He was then admitted to our hospital on June 21. The cause of the contracted bladder was not evident, despite extensive examination. A replacement ileocystoplasty constructed by Shishido's method was used to replace the contracted bladder. A U-shape pouch was prepared by detubularization of 25 cm of the ileum and this pouch was anastomosed to the incised end of the bladder neck after subtotal cystectomy. The ureter and ileum were then anastomosed using Coffey's method. The bladder capacity and the maximum urinary flow rate after 1 year were 350 ml and 13 ml/sec, respectively, and residual urine was not noted after urination even following abdominal pressure. Urinary incontinence was not noted either.