尿管静脈瘤に対する手術治療の経験

Abstract

尿管静脈瘤8例を経験した.7例は血尿を主症状とし, 残りの1例は精索静脈瘤に合併した例である.前者の7例に対し手術的静脈瘤結紮切除を施行し, 全例血尿は消失した.尿管静脈瘤の手術治療は血尿に対する対処的性格なものであるが, 効果は著明である

Ureteral varices have been considered to be a relatively rare disease. Recently, reports on varices have been increasing with the development of X-ray examination, especially with the popularization of renal phlebography. We diagnosed left ureteral varices in 8 cases by renal venography. In 7 of these cases, gross hematuria was the main symptom, and varicocele accompanied it in the other case. In 7 cases of hematuria, surgery, ligation and removal of the varices was performed as palliative therapy for symptom; and, in all 7 cases, the gross hematuria disappeared in 7 to 18 months postoperatively. Ureteral varices should be classified into idiopathic and secondary types. In the case of idiopathic varices, a regional operation is sufficient to prevent venous reflux of the ureteral vein, and extensive surgery is needed in cases of collateral circulation on the venograms and secondary varices because of the unchangeable postoperative venous hypertension. We concluded that surgical treatment of ureteral varices is effective and is a useful palliative procedure in spite of the short postoperative follow up.