尿勢低下を主訴に発見された左精囊内血腫に対して経皮的ドレナージが有効であった症例の検討

Effective drainage for dysuria due to cystic change of left seminal vesicle hemorrhage : A case report

　80歳男性．尿閉と肛門の奥の痛みを主訴に当科受診．造影MRIにて左精囊にニボーを有する液体成分を含有した径60mm大の腫瘤病変を認め，精囊内出血が疑われた．経直腸的超音波画像ガイド下経会陰的血腫ドレナージ術および精囊生検を施行．腫瘤の著明な縮小が認められた．生検では悪性所見は認められなかった．精囊内出血に対し，経直腸的超音波画像ガイド下経会陰的血腫ドレナージ術が有効である可能性が示唆された．

Abstract

An 80-year-old man presented with complaints of urinary retention and anal pain. Multi-parametric magnetic resonance imaging (MRI) showed the cystic change of the seminal vesicle 60mm in diameter, which was suspected due to hemorrhage. Transrectal ultrasound (TRUS) image-guided transperineal drainage was performed for the hemorrhage in the cystic seminal vesicle associated with seminal vesicle biopsy, resulting remarkable shrinkage of the cystic mass. The pathological findings of seminal vesicle revealed no malignancy. TRUS guided transperineal drainage would be one of the methods for the cystic change of the seminal vesicle due to hemorrhage (Rinsho Hinyokika 72 : 565-568, 2018).