Grade2以上の膀胱瘤の手術成績

A Clinical Study of Grade 2, 3and 4 Cystocele

　Grade2以上の膀胱瘤8例について，当科における手術成績を含め臨床的に検討した。手術の内訳は，grade2の1例，grade3の6例に腟前壁形成術＋Raz式膀胱頸部吊り上げ術を，grade4の1例には腟前壁形成術＋Raz式four-corner bladder and urethral　suspenslonを行った。手術成績は，1例に軽度の膀胱瘤再発と尿失禁を認めたものの，他の7例では膀胱壁の下垂は消失し良好な成績であった。術前後のチェーン膀胱尿道造影での変化をみると，尿道傾斜角，恥骨下縁に対する膀胱頸部の高さは術後有意に改善していた。尿流測定での変化をみると，残尿量，残尿率は減少傾向を示した。

Eight cystocele patients were treated by anterior coipor-rhaphy together with the Raz bladder neck suspension technique. One patient had grade 2, six had grade 3, and one had grade 4 cystocele according to Raz'sgrading criteha. During the follow-up period which averaged 5.9 months (3~11), complete disapperance of the cystocele was achieved in 7 patients. Only one patient had a clinically mild recurrence. In postoperative chain cystourethrogram,the angle of urethral inclination and the sacrococcygeal inferior pubic point were significantly improved.