経尿道的尿管瘤切開による上部尿路結石の完全排出

SPONTANEOUS PASSAGE OF UPPER URINARY STONES BY THE TRANSURETHRAL INCISION OF THE URETEROCELE

　23歳，女性，保母。IVPで右腎結石，右尿管結石像を認めた。右尿管は骨盤内で著明に拡張し，膀胱内の蛇頭状の陰影欠損に連続していた。膀胱鏡で右尿管口部に小鶏卵大の尿管瘤を認めた。単純性尿管瘤に合併した腎尿管結石と診断し，経尿道的に尿管瘤壁の一部のみを切除し，余剰部が新尿管口を覆うように，切開開放した。術後のIVPでは結石はすべて自然排石され，右水尿管症の改善もみられ，膀胱尿管逆流現象もみられていない。

A 23-year old female was hospitalized whose DIP revealed right renal and ureteral calculi and marked hydroureter connecting to the cobra-head shaped radioluscent area in urinary bladder. Small hen egg sized ureterocele at the right ureteral orifice was shown by cystoscopy. Above findings were compatible with simple ureterocele with staghorn-like calculus and marked hydroureter with ureteral calculus. Only a small portion of the wall was resected by TUR so that the shrunk proximal wall could cover the new orifice.