特発性巨大結腸症により尿閉となつた神経因性膀胱の1例

A CASE REPORT OF URINARY RETENTION DUE TO IDIOPATHIC MEGACOLON

　脳梗塞による神経因性膀胱のため薬物療法を施行していた58歳の男性が，尿閉を主訴に来院した。DIP，CTスキャン上，多量の糞便による膀胱頸部の圧排を認め，糞便貯留の原因は特発性巨大結腸症のためと判明した。外科にて，人工肛門造設およびS状結腸切除術が施行された。術後の下部尿路機能検査は術前と同様の神経因性膀胱の型を示し，薬物療法により再び自排可能となつた。

A 58 years old man who had neurogenic bladder due to cerebral infarction was presented with chief complaints of urinary retention and abdominal distention. Pelvic CT scan and DIP revealed that urinary retention occurred due to bladder-neck obstruction because of massive feces, which resulted from adult type idiopathic megacolon. Single barreled permanent artificial anus of sigmoid colon with sigmoid resection was performed by surgeons. Postoperative urodynamics study of lower urinary tract showed a type of neurogenic bladder which had been shown preoperatively and the patient has no further urinary disturbance by drug treatment.