自然排石された巨大な尿道結石

A case of giant female urethral calculus

　症例は80歳，女性。55歳の頃に脳梗塞を発症し，71歳頃より寝たきりとなり自宅で介護されていたが，肺炎のため入院し，尿道異物を指摘された。骨盤部単純X線写真で尿道に一致して大きな結石陰影が認められ，経尿道的結石破砕術を予定していたが，突然66×47×43mm，重量119gの巨大結石が自然排出された。結石分析はリン酸カルシウム，リン酸マグネシウム・アンモニウム，炭酸カルシウムの混合結石であった。

　A 80-year-old female with a urethral calculus who had neurogenic bladder due to cerebrovascular disease is presented. A plain X-ray of the pelvis demonstrated a large calculus at the urethra. The pelvic and vaginal examinations demonstrated a large calculus impacted at the external urethral meatus. The stone could neither be pushed up into the urinary bladder or through the meatus with forceps. A urethral calculus was discharged suddenly though an operation scheduled after the whole body condition improved. Gross examination of the stone revealed that calculus weighting 119g,and measuring 66×47×43mm. The stone was composed of calcium phosphate,calcium carbonate,and magnesium ammonium phosphate.