寝たきり女性高齢者に発症した大きな尿道結石

Large urethral calculus in a bedridden elderly female：A case report

　症例は80歳，女性。尿路感染症の精査・治療目的に入院した。腹部・骨盤CTにて尿道結石の嵌頓を認め，この結石は外尿道口から観察できるが可動性なく経尿道的にカテーテルを挿入することはできなかった。抗生物質投与にても改善せず，また認知症のあることより全身麻酔下に膀胱瘻カテーテル留置および外尿道口から結石摘出を行った。術後，尿路感染症は改善した。1年後の現在も再発なく経過している。

An 80-year-old female was admitted for the detailed examination and treatment of urinary tract infection. Abdominal and pelvic CT revealed a large stone impacted at the urethra. The calculus could be seen from the external urethral meatus,which was not movable,and transurethral insertion of a catheter was impossible. Administration of antibiotics did not achieve improvement. As she had senile dementia,a cystostomy tube was inserted under general anesthesia,and the stone,50×40×31mm,47gm was removed by grasping with forceps through the external urethral meatus. After surgery,urinary tract infection subsided. Postoperative course was uneventful with good urination for 1 year after the surgery.（Rinsho Hinyokika 60：501-503,2006）