空気圧式砕石装置での砕石が有効であった女子尿道憩室結石

Female urethral diverticulum calculi successfully treated with pneumatic jackhammer：A case report

　症例は64歳，女性。残尿感を主訴に当科を受診した。ファイバースコープにて尿道憩室結石を確認した。憩室口が広く，硬性尿管鏡の挿入が可能であったため，空気圧式砕石装置を用いて砕石を行った。尿道憩室結石に対する治療としては憩室切除術が一般的であるが，憩室口が広い場合，空気圧式砕石装置での破砕は低侵襲かつ短時間で行うことができ，治療選択肢の1つとなると考えられた。

　A 64-year-old woman consulted our hospital with a compliant of sensation of residual urine. KUB, pelvic CT and urethral fiberscope revealed a urethral diverticulum calculi measuring 7mm in diameter. Orifice of diverticulum was so wide, as we could insert rigid ureteroscope and perform transurethral lithotripsy with Lithoclast^® in urethral diverticulum. Disintegrated stones were migrated into bladder, and were evacuated. Only 18 minutes were needed for this operation. The stone was composed of calcium oxalate（88％）, and calcium phosphate（12％）. Transvaginal diverticulectomy is standard operation for urethral diverticulum calculus, however stone disintegration with Lithoclast^® takes short time for the operation without any postoperative complications. Lithoclast^® is useful option of operation for the treatment of diverticulum calculi.（Rinsho Hinyokika 61：351-353, 2007）