Hautmann回腸膀胱の術後成績と排尿状態の検討

Postoperative Results and Urodynamic Studies of the Hautmann's Ileal Neobladder

　当院で施行した半年以上を経過した膀胱全摘後のHautmann回腸膀胱の症例に対し，術後経過，合併症，および排尿状態を検討した。術後経過は大きな合併症はなく，安定していた。昼間の尿禁制は全例で得ることができ，1例のみで夜間の軽度尿失禁を認めた。半年を経過した時点での尿流動態検査では144±49秒と軽度の排尿の遷延を認めた他は，最大尿流量14.8±8.7ml／s，残尿26±37mlとほぼ満足できる結果であった。半年の経過で，上部尿路は全例に水腎症などの異常を認めなかった。多量の残尿が存在した症例は尿道吻合部の狭窄を認め，内視鏡的尿道切開にて速やかに排尿状態の改善を得た。Hautmann回腸膀胱は合併症も少なく，良好な結果を得られる術式と考えられた。

We evaluated our patient who underwent Hautmann's ileal neobladder and survived for more than 6 months after operation. Their postoperative course were stable and free of major complication. Daytime continence was achieved in all, however, one patient had nighttime incontinence. Urodynamic studies, which were performed 6 months after operation, revealed satisfactory profiles except for the mild prolongation of voiding time. The maximum urinary flow rate and residual urine were 14.8 ± 8.7 m//s and 26 ± 37m/ , respectively. Upper urinary tract remained normal in all at 6 months postoperatively.