人工尿道括約筋コントロールポンプを大腿内側皮弁内に再留置した1例

Artificial urinary sphincter control-pump re-implantation within the local flap at inner aspect of the thigh：A case report

症例は68歳，男性。前立腺癌に対する根治的前立腺全摘除術後に生じた尿失禁治療目的で人工尿道括約筋（AMS 800）埋込み術を施行したが，陰囊部感染のため全回路摘出を余儀なくされた。再埋込み術にあたり，高度に萎縮した陰囊にかえて，大腿内側に局所皮弁によるポケットを作成し，その中にコントロールポンプを留置した。術後1年を経過し，感染もなくポンプも容易に操作可能である。

A 68-year-old man underwent implantation of an artificial urinary sphincter（AMS 800）for post-radical prostatectomy incontinence,but the entire device was removed due to postoperative infection. When we planned second implantation,it was impossible to implant the pump-control assembly subcutaneously in the scrotum due to the severe scrotal contracture. So we made a skin pocket at inner aspect of the thigh with local flap prior to the second implantation. Eleven months later,the pump-control assembly was implanted within the skin pocket. The pump-control assembly is handled with ease and shows no signs of infection during our 1 year followup.