会陰部に穿孔した膀胱尿道異物

A CASE REPORT: VESICO-URETHRAL FOREIGN BODY PENETRATED PERINEUM

　42歳，男性，未婚。7年前に尿道にボールペンを挿入されたが放置。初診時，会陰部から頭を出したボールペンの抜去を試みるも不能。尿道造影で膀胱から前立腺部尿道を経て，会陰部を貫いたボールペンと，これを核にした結石を認めた。膀胱高位切開にて結石塊の付着したボールペンを摘出し瘻孔閉鎖術を行った。

　過去20年間に報告された膀胱尿道異物249例を集計した。本例は放置年数も長期であり，会陰部に穿孔を来した点でも稀な例であった。

A 42-year-old single male was admitted with a chief complaint of urinary incontinence. He stated that a ball-point pen was inserted into his urethra by his friend 7 years ago. Pain and pollakisuria developed but until incontinence and bad smell caused by perineal penetra-tion of the pen appeared, he hesitated to visit hospital. The ball-point pen was unable to take out from perineum. Urethrogram showed that the pen penetrated through his membranous urethra with a large bladder stone, which were removed suprapubically.