尿閉および左水腎症を来した子宮頸部筋腫

Urinary Retention and Left Hydronephrosis Caused by Uterine Cervical Myoma:A Case Report

　47歳，女性。尿閉を主訴に近医にて約600ml導尿したのち，当科へ紹介となった。触診上，下腹部に小児頭大の腫瘤を触れた。DIP上，左水腎症を認めた。骨盤部CTおよびMRI矢状断では著明に腫大した子宮が膀胱頸部を後方より圧排していた。チェーン膀胱尿道造影上，尿道は左側へ偏位していた。子宮筋腫による尿閉の診断で，当院産婦人科にて腹式単純子宮摘出術を施行した。術後2日目にバルーンカテーテルを抜去し，自排尿可能となった。

A 47-year-old woman was referred to our hospital for further examination of acute urinary retention. About 600ml urine was obtained by urethral catheterization. A child-head-size tumor was palpated by physical examination at the lower abdominal region. DIP showed left hydroneph-rosis. A pelvic CT and MRI revealed markedly enlarged myoma uteri which existed in the pelvis minor and pressed the bladder neck. A chain urethrocystography revealed the proximal urethra dislocated to the left. An abdominal total hysterectomy was performed.2 days after operation,she became able to void well.