虫垂利用禁制膀胱瘻を作成した再発性のフルニエ壊疽の1例

Continent Vesicostomy Using an Appendix Conduit for Recurrence of Fournier's Gangrene:A Case Report

　28歳，男性。突然の陰茎の腫脹を主訴に来院した。自己導尿が誘因となったフルニエ壊疽と診断し，デブリードマン，切開排膿を行った。自己導尿の再開によりフルニエ壊疽の再発を来すため，ミトロファノフの原則による禁制膀胱瘻を作成した。術後は，尿失禁はなく導尿も容易で，フルニエ壊疽の再発も認めていない。

A 28-year-old male with intermittent urethral self-cath-eterization for five years due to neurogenic bladder of a sacral tumor origin became unable to continue intermittent urethral self-catheterization because of recurrence of Fournier's gangrene occurred over penile prepuce. There-fore, continent vesicostomy using appendix condiut follow-ing Mitrofanoff principle was performed. Postoperatively, catheterization through the conduit induced no recurrence of Fournier's gangrene. The appendix conduit following Mitrofanoff principle is considered one of the best urinary diversion in case with difficulty in self-catheterization.