膀胱全摘後も自尿，勃起が可能であった若年膀胱癌

RADICAL CYSTECTOMY AND ILEOCYSTOPLASTY PRESERVING URINARY CONTINENCE AND ERECTION IN A YOUNG MAN WITH BLADDER CANCER

　18歳で発症した再発性の表在性膀胱腫瘍に対して経尿道的腫瘍切除術，放射線療法，膀胱内注入療法を施行したが，2年後に，肺に遠隔転移を生じた．そのため転移部位の右中肺葉切除術，神経温存根治的膀胱全摘術，回腸を利用した膀胱形成術を施行した．再び肺転移を生じたため右下肺葉切除を行い，術後の補助化学療法中に逆流防止弁の狭窄による急性腎不全を生じたため逆流防止弁の修復術を施行した．以後，自尿可能で完全な尿禁制が維持され勃起も可能である．

A 21-year-old man with 2 years' history of superficial bladder cancer had undergone TUR, intravesical instillation of anticancer agents and radiation. Since pulmonary metastasis developed, he underwent right middle lobectomy, nerve-sparing radical cystectomy and open-flap ileocystoplasty with intussucepted ileal valve for anti-reflux. Pulmonary metastasis reappeared and right lower lobectomy was done. During postoperative adjuvant chemotherapy, he developed acute renal failure owing to a stricture of the intussusce-pted ileal portion. The stricture was surgically repaired.