排尿筋過反射型収縮不全を認めた間質性膀胱炎

A case of interstitial cystitis with detrusor hyperactivity with impaired contractile function

患者は70歳，女性。間質性膀胱炎に対し膀胱水圧拡張術および高気圧酸素療法を施行。膀胱部痛は消失するも，1か月後に頻尿症状が増悪したためトルテロジンを投与したが改善が得られず，病態の把握のためpressure-flow studyを施行した。Detrusor hyperactivity with impaired contractile functionと診断し，ウラピジルおよびイミダフェナシンを投与したところ，症状は改善した。

A 70-year-old woman visited our hospital with a chief complaint of pollakisuria and bladder pain. Under the diagnosis of interstitial cystitis,we performed hydrodistention and hyperbaric oxygen therapy,by which she became completely relieved from bladder pain. One month after the therapy,the patient developed pollakisuria,whereas bladder pain had remained relieved. Tolterodine was prescribed,but no improvement was obtained. We performed pressure-flow study and diagnosed the condition as detrusor hyperactivity with impaired contractile function. With proper medication,pollakisuria markedly improved.