尿管瘤の自然破裂による膀胱尿管逆流

SPONTANEOUS RUPTURE OF A SIMPLE URETEROCELE WITH REFLUX

　40歳，男性。肉眼的血尿および，排尿困難を主訴に来院。膀胱鏡にて左三角部に尿管瘤を認めた。膀胱造影にて左膀胱尿管逆流をみたため，尿管瘤切除術および尿管膀胱新吻合術を施行した。術中所見にて瘤内に尿管口とは別に，バルブ状になっているV字型の開口部を認めた。このことより，単純性尿管瘤に自然破裂を生じてバルブ状の開口部ができ，その開口部を通して膀胱尿管逆流を起こしたものと診断した。

A 40-year-old man with gross hematuria and difficulty of urination had a large floppy left-sided orthotopic ureterocele. A cine-cystogram revealed reflux on the left side. The ureterocele was excised and ureteroneocystostomy was performed. At operation we found two openings, one gaping V-shaped and the other stenotic. It was concluded that free reflux occurred into the simple ureterocele that had been spontane-ously ruptured.