経尿道的前立腺切除術で水腎が改善した神経因性膀胱の1例

TRANSURETHRAL RESECTION OF THE PROSTATE FOR A MALE PATIENT WITH NEUROGENIC BLADDER ACCOMPANIED WITH COMPLICATIONS OF THE URINARY TRACT : A CASE REPORT

　膀胱変形，両側水腎水尿管を呈した男性神経因性膀胱患者に対し，前立腺尖部において，前立腺外腺をも解剖学的被膜のレベルまで広範に切除する経尿道的前立腺切除術を施行した．術後，両側水腎症の消失，膀胱コンプライアンスの増加をみ，膀胱変形も改善した．現在，軽度の尿失禁を認めるが，排尿状態は良好で，日常生活に支障はない．本手術は，尿路荒廃をともなう男性神経因性膀胱患者への治療として有用であると思われた．

Transurethral resection of the prostate (TUR-P) was performed to the level of the anatomical capsule around the prostatic apex for a 53 year old male patient with chronic neurogenic bladder accompanied with bladder deformity and bilatelal hydronephrosis. After this radical TUR-P, bladder deformity and bilateral hydronephrosis were improved. Vesical compliance increased and the voiding condition became also better. From this interesting result we suggest that radical TUR-P was an effective treatment for male patients with neurogeinc bladder accompanied with complications of the urinary tract.