子宮悪性腫瘍の治療前泌尿器科検査における臨床的検討

Abstract

1980年1月～1984年12月の5年間に婦人科よりの依頼で子宮悪性腫瘍66例の治療前検査を行った.33～83歳, 平均55.4歳であった.子宮頸癌55例, 子宮体癌10例が主である.Stageは1・23例, 2・28例であった.泌尿器科的症状は4例と少なく, 子宮病変と特別の関連はなかった.尿は15例が異常を呈し, 血尿12例, 膿尿10例で, 前者は腫瘍病変の尿路への影響, 後者は二次的尿流障害や免疫力低下に関係がある.膀胱鏡検査では62例中32例に異常を認め, うち膀胱壁の隆起は11例で重要な所見であった.浮腫を11例, 発赤を3例に認めた.その他出血1例, 肉桂形成4例, Leukoplakia様変化1例, 尿管口の異常などをみた.IVUは58例に施行した.水腎症を6例, 膀胱の変形を28例, 膀胱容量の減少を1例に認めた

Sixty six cases of uterus malignant tumors examined urologically before gynecologic treatment between 1980 and 1984 are reviewed retrospectively. The uterus lesion excluding 1 malignant mixed mesodermal tumor was cervical carcinoma in 55 cases and corpus carcinoma in 10 cases. Pathologically, 46 cases were squamous cell carcinoma, 10 were adenocarcinoma, 3 were squamous adenocarcinoma and 6 were unknown. Clinical staging according to classification of FIGO, was stage 0 in 3 cases, stage I in 23 cases, stage II in 28 cases, stage III in 3 cases, stage IV in 7 cases, and unknown in 2 cases. Only 4 cases (6.1%) had urological symptoms with no special relationship to the uterus lesion. Abnormal findings of urine tests were seen in 15 cases (22.7%). The incidence of hematuria and pyuria, which were seen in 12 and 10 cases, respectively, was high. Cystoscopic abnormality was revealed in 32 (51.6%) out of 62 cases. Protrusion of vesical wall was found in 11 cases (34.3%) and it was an important finding which showed a significant incidence. Edema was seen in 11 cases (34.3%). This was a sign of progression, and the observation on spread of lesion was important. Redness was seen in 3 cases (4.8%). It was considered to be the result of circulatory disturbance. At the same time observations on vascular change, edematous change etc. should be done in detail. Bleeding was seen in 1 case (1.6%), microscopic bleeding was seen more frequently than macroscopic bleeding. Abnormalities of ureteral orifice were significant only after other examinations were reviewed in addition to these signs. IVU was performed in 58 cases.(ABSTRACT TRUNCATED AT 250 WORDS)