外尿道口より逸脱した尿管ポリープの1例

Abstract

A 40-year-old house-wife was seen with flank pain on the left side, burning on urination, urgency of almost incontinent state, bloody spot on the underwear and a mass at the external urethral meatus. Pyrexia, gross hematuria and difficulty in urination were all not recognized since the beginning of the disease. Urinalysis showed red blood cells (+ + +) and white blood cells (+). KUB showed no stone shadow. Drip infusion pyelography revealed hydronephrosis on the left side whereas normal kidney on the right and bladder. The mass at the external urethral meatus appeared almost walnut-sized. It was resected. The ligature placed on the pedicle then retracted into the bladder by itself. Cystoscopy disclosed a mass with the ligature material located at the left ureteral orifice. Retrograde pyelography on this side was normal. Partial resection of the bladder including the lowest part of the left ureter and ureteroneocystostomy were performed. The tumor was found to have originated from the lowest end of the ureter. Postoperative course was uneventful. Histologically, the mass at the external meatus was highly vascular granuloma, and the ureteral mass was also granuloma. Final diagnosis was made as the granulomatous polyp of the ureter prolapsing through the external urethral meatus.