骨盤臓器脱加療中に発見された膀胱腫瘍

A case report：incidental finding of bladder tumors during the treatment of pelvic organ prolapse

症例1は61歳女性。腟断端脱に対し前医で手術を施行。術後の膀胱鏡検査で乳頭状腫瘍を認め，当科で経尿道的膀胱腫瘍切除術（TURBT）を施行，尿路上皮癌，G2＞1，pTaと診断した。症例2は64歳女性。臓器下垂にて受診。TVM（tension-free vaginal mesh）手術を予定したが，術前の膀胱鏡検査で乳頭状腫瘍を認めTURBTを施行，尿路上皮癌，G1，pTaと診断した。骨盤底疾患と膀胱腫瘍の好発年齢は重複し，偶発的に診断に至る膀胱腫瘍もあるため，臓器脱手術に際し，膀胱鏡検査が有用であると思われた。

First case was a 61-year-old woman with post-hysterectomy vaginal vault prolapse was incidentary found to have a papillary tumor located near to right ureteral orifice. TUR-BT was performed and histological examination revealed urothelial carcinoma, G2＞1, pTa. Second case was, a 64-year-old woman presented to our hospital with cystocele. Cystoscopy was performed before TVM（tension-free vaginal mesh）technique. A papillary bladder tumor was found at bladder dome. TURBT was performed, and the histological examination revealed urothelial carcinoma, G1, pTa. Epidemiologically, the prevalence of bladder tumor and pelvic organ prolapse of women are similar in age liability. Therefore it is useful to perform endoscopic examination before prolapse repair surgery.