尿道外脱出を伴った尿管瘤の医原性破裂

Iatrogenic rupture of prolapsed ureterocele in adult female

症例は21歳，女性。排尿困難と会陰部腫瘤を主訴に受診。産婦人科医により腟囊胞と診断され切除術を受けたが，直後に肉眼的血尿が出現した。その後のDIPにて両側単純性尿管瘤と診断され，尿管瘤切開術を施行しようとしたところ，左尿管瘤は既に破裂していた。切除した腟囊胞と尿管瘤の病理所見が一致したため，尿道外脱出した左尿管瘤を切除したことによる医原性破裂と考えられる。

Prolapse of a orthotopic simple ureterocele through the urethra is uncommon in adult female. We report a case of iatrogenic rupture of prolapsed ureterocele in a 21-year-old woman with a complaint of macroscopic hematuria. Originally she presented with a vaginoperineal mass and urinary retention,which was excised immediately by gynecologist under the diagnosis of vaginal cyst at our emergency room. Further examination disclosed prolapsed ureterocele,which had already been excised. To our knowledge no case of iatrogenic rupture of prolapsed ureterocele has been reported previously.