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Title: 子宮全摘除術後に泌尿器科的処置を必要とする高度排尿障害についての多施設実態調査
Other Titles: Multi-institute survey on actual conditions of urologic management for severe bladder dysfunction after hysterectomy
Authors: 吉村, 耕治  KAKEN_name
賀本, 敏行  KAKEN_name
岡田, 卓也  KAKEN_name
川喜田, 睦司  KAKEN_name
池田, 浩樹  KAKEN_name
林, 正  KAKEN_name
山本, 雅一  KAKEN_name
金丸, 洋史  KAKEN_name
増井, 仁彦  KAKEN_name
奥野, 博  KAKEN_name
青山, 輝義  KAKEN_name
寺井, 章人  KAKEN_name
東, 新  KAKEN_name
西尾, 恭規  KAKEN_name
石戸谷, 哲  KAKEN_name
奥村, 和弘  KAKEN_name
中嶋, 正和  KAKEN_name
七里, 泰正  KAKEN_name
上田, 朋宏  KAKEN_name
岡, 裕也  KAKEN_name
福澤, 重樹  KAKEN_name
岡村, 靖久  KAKEN_name
野々村, 光生  KAKEN_name
岡所, 広祐  KAKEN_name
瀧, 洋二  KAKEN_name
大西, 裕之  KAKEN_name
諸井, 誠司  KAKEN_name
西村, 一男  KAKEN_name
伊藤, 哲之  KAKEN_name
添田, 朝樹  KAKEN_name
佐々木, 美晴  KAKEN_name
伊藤, 将彰  KAKEN_name
小倉, 啓司  KAKEN_name
小川, 修  kyouindb  KAKEN_id
Author's alias: Yoshimura, Koji
Kamoto, Toshiyuki
Okada, Takuya
Kawakita, Mutsushi
Ikeda, Hiroki
Hayashi, Tadashi
Yamamoto, Masakazu
Kanamaru, Hiroshi
Masui, Kimihiko
Okuno, Hiroshi
Aoyama, Teruyoshi
Terai, Akito
Higashi, Shin
Nishio, Yasunori
Ishitoya, Satoshi
Okumura, Kazuhiro
Nakajima, Masakazu
Shichiri, Yasumasa
Ueda, Tomohiro
Oka, Hiroya
Fukuzawa, Shigeki
Okamura, Yasuhisa
Nonomura, Mitsuo
Okasho, Kosuke
Taki, Yoji
Onishi, Hiroyuki
Moroi, Seiji
Nishimura, Kazuo
Ito, Noriyuki
Soeda, Asaki
Sasaki, Miharu
Ito, Masaaki
Ogura, Keiji
Ogawa, Osamu
Keywords: Uterine cancer
Hysterectomy
Radiation
Voiding dysfunction
Clean intermittent catheterization
Issue Date: Jun-2008
Publisher: 泌尿器科紀要刊行会
Journal title: 泌尿器科紀要
Volume: 54
Issue: 6
Start page: 401
End page: 405
Abstract: 泌尿器科20施設を対象に, 清潔間欠自己導尿(CIC)管理を行っている成人女性患者について調査を行った。該当患者は287例(中央値70歳)で, 原因疾患で多かったのは子宮癌99例(中央値71.5歳), 次いで脊椎・脊髄疾患, 糖尿病, 脳疾患であった。子宮癌例において, 術後経過期間は中央値21年, CIC導入までの期間は術後4.0年であった。術後放射線療法併用ありは44例(A群), なし30例(B群), 不明20例で, B群では導入が必要な患者の約60%は術後1年以内に導入され, 20年までに約20%が導入された。A群では術後1年以内が約30%, 20年までに約50%が導入された。膀胱の自然破裂は11例にみられ, 全例放射線療法後であった。子宮癌術後から膀胱破裂までの期間は中央値16年で, 1例を除きCIC導入の契機となっていた。CIC以外の尿路系処置を要していたのは74例で, 放射線併用あり13例, なし61例であった。放射線併用なし群では尿管皮膚瘻, あり群では尿道へのフォリイカテーテル留置, 腎瘻造設が多かった。
We conducted a multi-institute survey on the conditions related to urologic management of severe voiding dysfunction after hysterectomy for uterine cancer with or without postoperative irradiation. Our first study population was a group of adult female patients currently managed by urologists, using clean intermittent catheterization (CIC). Of the 287 patients in this group, 99 (34%) had suffered from uterine cancer. Of these patients, 94 underwent hysterectomy for this disease; 44 and 30 were treated with or without postoperative radiation, respectively, while postoperative irradiation status was unknown for 20. Median follow-up after surgery was 21 (0.2-52) years and median interval from operation to the introduction of CIC was 4.0 (0-49) years. CIC tended to be introduced later for patients with postoperative radiation than those without it. Seventy-four patients, who required invasive urologic interventions other than CIC for voiding dysfunction after hysterectomy, are the second study population. Most of these (82%) had received postoperative irradiation. Continuous Foley catheter placement was the most frequent procedure. Long-term follow-up and urologic management for voiding dysfunction is required for patients undergoing hysterectomy.
Rights: 許諾条件により本文は2009-07-01に公開
URI: http://hdl.handle.net/2433/71694
PubMed ID: 18634434
Appears in Collections:Vol.54 No.6

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