根治的膀胱全摘後のインポテンス症例における陰茎inflatable prosthesis挿入手術の経験

Abstract

48歳男, 膀胱全摘出後のインポテンス例, Inflatable prosthesisの陰茎内挿入手術を施行したので, 手術所見を報告した.本邦でのこのプロステーシス挿入手術報告は調べた限りでは過去にない.このInflatable prosthesisを本邦で使用するには, サイズ特に陰茎シリンダーの直径に問題があると思われる.すなわち, 著者らが通常使用するsemirigid prosthesisの直径は通常9～8.5 mmで, 12 mmのシリンダーを挿入できる例は限られている.今後9 mm程度の太さのシリンダー, より小型の液体貯留槽とポンプの開発が期待される

The hydraulically inflatable penile prosthesis consists of an inflate-deflate pump, a storage reservoir and paired cylinders and it is able to provided a more physiologically functional penis. We report our surgical experience of implant of an inflatable penile prosthesis for postoperative impotence. The patient was a 51-year-old male with impotence, who had received radical cystectomy and ilial conduit formation for transitional cell carcinoma of the bladder (G3, pT3NoMo.) 9 months earlier. There was nothing particular except for the postoperative status on physical, laboratory and X-ray examinations. He was diagnosed to have organic impotence (vasculogenic) by sexual functional tests. Auto-injection of the corpus cavernosum with papaverine HCl was attempted but an erection was not induced by the injection. So, implant operation of an inflatable penile prosthesis was performed by the lower abdominal approach. His postoperative course was uneventable and practice to deflate and inflate the cylinders was started at 2 weeks after the operation and he was able to have sexual intercourse at 5 weeks after the surgery. Now (3 months after the operation), he can have sexual intercourse with an orgasm but without ejaculation and he and his wife are both satisfied with the postoperative status.