子宮筋腫と排尿異常の検討 : 経腹的子宮単純全摘出術の影響

Abstract

子宮筋腫のため経腹的子宮単純全摘出術をうけた68症例を対象とした。術前に1項目以上の排尿症状を有した患者は81%と高率であったが, 術後47%へ有意に減少した(p<0.01)。手術の結果, 腹圧性尿失禁, 弱い尿線, 努責排尿, 尿線中絶, 尿意切迫感, 昼間頻尿の6項目は有意に改善した(p<0.01または, p<0.05)。手術前の排尿症状と摘出子宮重量との相関を検討したところ, 尿線中絶は子宮軽量群(≦400g)に, 尿意切迫感は子宮重量群(>400g)に多く存在した(p<0.05)

We prospectively investigated micturition function in 68 women who were operated on by transabdominal simple hysterectomy for uterine myoma. Twelve parameters including stress urinary incontinence, obstructive symptoms, irritative symptoms, uroflow curves and amount of residue were subjectively or objectively evaluated before surgery and a mean of 4.4 months post-operatively. Though 55 patients (81%) had had one or more symptoms of micturition disorders prior to operation, surgery significantly reduced this number to 32 (47%) (p < 0.01). Hysterectomy significantly decreased the number of patients suffering from stress urinary incontinence, weak urinary stream, straining micturition, interrupted stream, urgency and frequency in the daytime. The relationship between the weight of the uterus removed and pre-operative symptoms of micturition disorders was assessed. Interrupted stream was present significantly more in the patients with a uterus weighing less than 400 grams and urgency in the patients with a uterus weighing more than 401 grams. We conclude that transabdominal simple hysterectomy is of use to improve micturition disorders pre-operatively recognized.