膀胱尿管逆流に対するPolitano-Leadbetter膀胱尿管形成術について

Abstract

There are over twenty original or modified methods for surgical correction of vesicoureteral reflux. In Department of Urology, Osaka University Hospital 51 ureters in 32 cases have been operated with three surgical techniques, namely Politano-Leadbetter (74 %), Panuin (16 %) and Gregoir (10%) with the successful results of 94 % during recent 5 years. Politano-Leadbetter's vesicoureteroplasty was reported as intravesical procedure with a submucosal tunnel for surgical correction of vesicoureteral reflux in 1958. However, in our country this method is often misunderstood as combined procedure using intra-and extravesical dissection of ureter that would lead to many disadvantages and abused to ureterovesiconeostomy. A purpose of this paper is to present Politano-Leadbetter's vesicoureteroplasty as intravesical procedure which is simpler and gives less damage to ureterovesical and trigonal function comparing to combined procedure. Also it is pointed out that Politano-Leadbetter's vesicoureteroplasty at present is slightly different from original procedure which was reported in 1958, namely the blunt penetration of vesical wall from the outside to the inside and resection of the original ureteral orifice.