陰茎絞扼による陰茎壊死

NECROSIS OF THE PENIS STRANGULATED BY A RUBBER BAND

　精神病院入院中の42歳男性。尿閉と陰茎部腫脹を主訴に近くの泌尿器科医を受診，陰茎根部が輪ゴムにて絞扼されていた。絞扼期間は不明で，輪ゴムを除去するも症状改善しないため当科紹介受診。陰茎全体は黒色調に腫脹し，外尿道口は癒着閉鎖していた。導尿は不可能であったため膀胱瘻造設術を施行，保存的治療を試みたが，絞扼部より自潰，尿道皮膚瘻を形成し，輪ゴム除去後19日目に陰茎切断術を施行した。

A 42-year old mentally retarted male was referred to our clinic because of urinary retention and swollen penis. The penis was incarcerated by a rubber band that was placed by himself tightly around the penile shaft in hopes to prevent urinary incontinence. As the urethral catheterization was unsuccessful due to obliterated urethral orifice suprapubic cystostomy was performed after the band was removed. However the penis developed to necrosis, forming a urethral fistula. Therefore, the penis was amputated on the 19th day after the removal of rubber band.