消化管を用いた尿路変向術, 尿路再建術を受けた患者における感染性尿路結石危険因子の検討 : 蓄尿型膀胱と回腸導管の比較

Abstract

蓄尿型人工膀胱(リザーバー, R群)12例, 回腸導管術10例(C群)で術施行後2ヵ月で感染性尿路結石の危険因子および予防因子を調べた。両群間に危険因子および複数の危険因子の陽性率に有意差がなかった。しかしR群の4例は複数の危険因子を持ってリザーバー内に結石を生じたが, C群ではなかった。R群では1個の危険因子より複数の危険因子を持つものの結石発生率は有意に高かった。56歳の回腸導管術の症例を提示した

Urinary risk factors and preventive factors for infectious calcium (Ca) urolithiasis formation, such as citrate, oxalate, Ca, phosphate, magnesium, and uric acid were examined more than 2 months after performing a urinary reservoir in 12 patients (R group) and ileal conduit in 10 patients (C group). There was no difference in the positive rate of risk factors between the two groups and also no difference in the positive rate of more than two risk factors between the two groups. Although four patients with more than two risk factors in the R group suffered from reservoir stones all of which included Ca-urolithiasis, none in the C group did. In the R group, the incidence of stone formation in patients with 2 or more risk factors was significantly higher than those in patients with 1 or no risk factor. In conclusion, the urinary reservoir operation should not be carried out in patients with more than two risk factors for urolithiasis formation, and urinary risk factors should be examined before reservoir operation.