難治性膀胱出血に対する両側内腸骨動脈分枝の選択的塞栓術

Abstract

Three cases with intractable massive bladder hemorrhage secondary to cystitis of unknown etiology, radiation cystitis, or primary bladder cancer, were treated with bilateral hypogastric branch artery occlusion by angiographic placement of inert material. In all the three cases, bladder hemorrhage was controlled effectively without significant complication. Therapeutic alternatives for intractable bladder hemorrhage are reviewed and estimated briefly on the ground of hemostatic effectiveness and complication with particular emphasis on angiographic arterial occlusion. In order to lessen the side effect and obtain the effective hemostasis for control of intractable bladder hemorrhage with arterial embolization, it is desirable to embolize arteries which are confined to the anterior division of hypogastric artery and to embolize more peripheral arteries as possible with minute particle.