Neuro-Behçet症候群による神経因性膀胱の1例

NEUROGENIC BLADDER DUE TO NEURO-BEHçET SYNDROME:A CASE REPORT

はじめに

　Neuro-Behçet症候群の患者では，ほとんど全中枢神経領域にわたる病変に対応する症状が報告されている^1〜3）。これらの症状の中に直腸膀胱障害も含まれているが，膀胱障害に関しては泌尿器科的検査を行なつた報告は私たちの調べた限りではほとんど皆無と言つて良いと思う。今回私たちは，尿路感染を主訴としたNeuro-Behçet症候群の患者に，当教室で行なつている一連の下部尿路機能検査法^4）を行なつた結果，本症例の膀胱障害はbladder-sphincter dyssynergia typeの神経因性膀胱であるという知見を得た。また，私たちは，これらの知見にもとづき本症例の治療として尿道外括約筋切開術^5）を行ない，尿路感染の防止に良い結果を得たので二，三の検討を加えて報告する。

A case of neurogenic bladder with the recurrent upper urinary tract infection due to Neuro-Behçet syndrome was presented.

A 32-year-old man had been suffering from recurrent upper urinary tract infection. When he was 25 years old, he was diagnosed as Behçet syndrome by a ophthalmologist, and 5 years later, he was diagnosed as neuro-Behçet syndrome by a neurologist. Routine urological examinations, urodynamic study and neurological examination were performed at our clinic. We suspected that the recurrent upper urinary tract infection was caused by what we call bladder-sphincter dyssynergia and VUR.