尿管S状結腸吻合術の再検討 第4報 : 術後生活状況

Abstract

Eighteen patients in state of ureterosigmoid anastomosis were observed on their general condition and state of evacuation of urine and stool. Residual urine in the intestine was estimated with rectosigmoidography which was carried out in 15 of the 18 cases. From our observations, the following conclusions might be made. 1) As to the evacuation of urine and stool, evacuation became more frequent than preoperative defecation in almost all of the cases. 2) It was one of the important causes of the frequent evacuation that the patients could not pass intestinal gas separately. They usually passed gas with a small amount of urine. Nocturnal incontinence also occasionally occurred in 12 of the 18 patients. We believe that the incontinence, although a little in volume, develops when the intestinal gas passes while sleeping deeply. These problems; frequent evacuation, and production and discharge of the intestinal gas should be further studied and controlled in future. 3) Generally, continence after the operation was almost satisfactory. However, hypotonia of the anal sphincter and other anal diseases, such as hemorrhoid or prolapse have to be carefully checked before the operation is performed. 4) Typical symptomatic pyelonephritis occurred in 40% of the 18 patients, and further more asymptomatic pyelonephritis might be present. 5) General condition of daily life of the patients after the operation was almost satisfactory and comfortable because the patients had no external urinary fistula. Some significant problems are still present, but we believe that ureterosigmoid anastomosis is still one of the useful operations for urinary diversion after radical operation.