後部尿道への異所開口を伴う閉鎖尿管膿瘍

An Abscess of Ureter Atresia with Ipsilateral Renal Agenesis and Ectopic Ureteral Opening: A Case Report

　18歳，男性。3年前より排尿時の陰茎痛，右下腹部痛を頻回に訴えていた。CT上，右腎は欠損しており，膀胱右後方に嚢胞性腫瘍がみられた。IVPでは右腎は造影されず，膀胱の変形はなかった。尿道造影，精管造影，排尿時膀胱造影では異常がなかった。嚢胞は自然に縮小したが，今回再び排尿時痛とともに嚢胞が出現した。閉鎖尿管膿瘍と診断し，経尿道的に膀胱壁を切開して排膿を行った。術後経過は良好で，合併症もなく，症状は改善している。

A 18-year-old man visited our hospital complaining penile pain on urination for three years. Abdominal CT demon-strated the absence of right kindney and a cystic mass behind the bladder. IVP showed no filling defect in the bladder. Urethrocystography, vasovesiculography and void-ing cystureteropraphy were normal. 4 months later the cystic mass disappeared spontanously with his complaint improved. However, the cystic mass in CT reappeared associated with pain on urination 2 years later. Under the diagnosis of an abscess of ureter atresia, drainage of the abscess was performed by transurethral incision of the bladder wall.