遺尿症を主訴に発見された小児球部尿道狭窄症

Congenital narrowing of the bulbar urethra with enuresis

症例は11歳，男児。生来みられた昼間遺尿と夜尿を主訴として来院した。排尿時膀胱尿道造影にて，後部尿道の著明な拡張，球部尿道の狭窄を認め，膀胱内圧測定にて無抑制収縮が確認された。遺尿症の原因として下部尿路閉塞に伴う過活動性膀胱が考えられ，経尿道的尿道狭窄切開術を施行した。術後は尿流量測定の改善がみられ，無抑制収縮消失も確認された。昼間遺尿は消失し，夜尿の頻度も週3回に減少した。

An 11 year-old boy with congenital narrowing of the bulbar urethra presented complaining innate diurnal and nocturnal enuresis. The frequency volume chart revealed that the functional bladder volume was low for his age,and judging from nocturnal urine volume with its specific gravity,we regarded his symptoms caused by detrusor overactivity. A voiding cystgram revealed remarkable dilation of the posterior urethra,with narrowing of the bulbar urethra. Cystmetry revealed un-inhibited contraction of the bladder. Under the suspected diagnosis of overactive bladder caused by lower urinary tract stricture,patient underwent transurethral incision of the urethra. After surgery,uroflometric findings were improved,and uninhibited contraction disappeared,and enuresis became controllable. At present,he has no sign of recurrence,and has no need of additional medication.