記述言語：日本語   出版者・発行元：新潟医学会  

【目的】新潟大学地域医療教育センター・魚沼基幹病院は新潟県魚沼医療圏域の中核病院として2015年6月に開院した。開院してからこれまでの緊急尿路処置を必要とした患者を集計し検討した。【対象と方法】2015年6月〜2017年8月の期間で、緊急の尿路処置を行った44例を対象とし、原因疾患、病態、処置内容について検討した。【結果】症例は男性20例、女性24例、年齢(中央値)は68.0歳(31〜93歳)であった。原因疾患は、結石性腎盂腎炎22例(50%)、腎後性腎不全19例(43%)、尿管損傷1例(2.2%)、腎膿瘍(2.2%)、膀胱内異物1例(2.2%)であった。結石性腎盂腎炎では、左10例、右11例、両側1例で左右差はなく、敗血症を合併した症例が9例(44%)認めた。そのうち、基礎疾患に糖尿病を認めた症例は4例(25%)であった。尿路感染症の起因菌はE.coliが12例(55%)で最も多かった。処置内容は尿管ステント留置術が17例で最多であり、続いて腎瘻造設術が3例、経尿道的結石破砕術が2例であった。結石性腎盂腎炎症例は緊急処置ならびに抗菌療法にて軽快した。腎後性腎不全の原因疾患は、尿路結石によるものが5例で、腫瘍の浸潤が原因であるものが14例(前立腺癌4例、膀胱癌3例、後腹膜線維症3例、胃癌播種2例、後腹膜脂肪腫1例、子宮体癌再発1例)であった。処置内容は、結石症例で尿管ステント術留置術3例、経尿道的結石砕石術2例施行され、腫瘍浸潤症例では尿管ステント術留置術8例、腎瘻造設術6例であった。腎機能は、術前で結石症例はCre 3.1±2.0ml/dl(eGFR 59.8±6.0ml/min)、腫瘍浸潤症例ではCre 5.3±6.0ml/dl(eGFR 24.4±25.9ml/min)であったが、術後はそれぞれCre 0.83±0.34ml/dl(eGFR 59.8±6.0ml/min)、Cre 1.3±0.61ml/dl(eGFR 49.9±28.6ml/min)と共に改善を認めた。【結論】結石性腎盂腎炎などに対しては主に尿管ステント留置術が、腫瘍浸潤等による尿管閉塞症例では主に腎瘻造設術が選択された。本検討の結果、魚沼医療圏域においても泌尿器科疾患に対する緊急対応の需要は高いことが明らかになり、当院の重要性が再認識された。(著者抄録)

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記述言語：英語  

DOI： 10.1016/j.eucr.2017.09.017

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器内視鏡学会  

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記述言語：日本語   出版者・発行元：新潟医学会  

前立腺癌疑い患者に対して前立腺生検が行われるが、全身麻酔または腰椎麻酔管理による前立腺生検では通常1〜2泊の入院管理で行うことが多い。また日帰り前立腺生検では局所麻酔で行われることが多く、局所麻酔時や穿刺時に患者の苦痛が伴う。我々は2016年1月から全身麻酔管理による日帰り前立腺生検を行っている。全身麻酔管理による日帰り前立腺生検を行うにあたり「全身麻酔管理による日帰り前立腺生検クリニカルパス」を作成し行っている。前日夕食後は禁食とし、生検当日は水分を朝6時まで可とし、午前中に全身麻酔管理による日帰り前立腺生検を行う。前立腺生検はReal-time Virtual Sonography(RVS)を用いたMRI-経直腸的超音波検査同期狙撃生検3-6ヶ所、系統生検左右各5ヶ所の計13〜16ヶ所の経会陰的前立腺生検を行う。前立腺生検後3〜4時間経過観察し、帰宅時チェックリストを用いてすべての項目で問題がないことを確認後帰宅する。2016年12月までの12ヵ月間に67例に全身麻酔管理による日帰り前立腺生検を施行した。1例で術後膀胱タンポナーデを、1例で術後尿閉を経験したが、再入院を必要とした症例はなく、そのほか周術期に問題となった症例はなかった。全身麻酔管理による日帰り前立腺生検は患者の苦痛が少なく、有用な方法と考えられる。(著者抄録)

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記述言語：英語  

A 38-year-old female without the tuberous sclerosis complex was diagnosed with right renal angiomyolipoma of 10 cm in diameter. She underwent laparoscopic retroperitoneal nephron-sparing surgery without renal artery clamping with preoperative selective arterial embolization to avoid a significant risk of hemorrhage and the damage of the renal function during nephron-sparing surgery. The tumor was resected completely. The time taken to complete the procedure was 4 hours 11 minutes and blood loss was 780 mL. She was transfused 400 mL of autologous blood.

DOI： 10.1089/cren.2016.0133

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記述言語：英語  

A 20 years old woman had an external urethral orifice mass and received an excision operation. Seven years later, she complained a tumor with pain that was similar to the previous tumor. She underwent the tumor removal. Pathological diagnosis was a urethral angiomyomatous leiomyoma in the new concept of estrogen receptor-positive smooth muscle tumors.

DOI： 10.1016/j.eucr.2016.08.006

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記述言語：英語  

Testicular seminoma is a relatively common testicular cancer; however, testicular seminoma with pseudocyst is an extremely rare. The 'burned-out' phenomenon in germ cell tumors refers to a germ cell tumor in extra-gonadal tissues with spontaneous regression of an intra-gonadal tumor. We present a case of the testicular seminoma with pseudocyst and coagulation necrosis like burned-out tumor without metastasis.

DOI： 10.1016/j.eucr.2016.03.010

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1038/nrurol.2016.9

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器内視鏡学会  

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記述言語：日本語   出版者・発行元：(一社)日本排尿機能学会  

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記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J00990&link_issn=&doc_id=20141225160022&doc_link_id=%2Fdg3nigta%2F2014%2Fs12808%2F014%2F0408-0408%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdg3nigta%2F2014%2Fs12808%2F014%2F0408-0408%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：新潟医学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2013&ichushi_jid=J00990&link_issn=&doc_id=20131028080036&doc_link_id=%2Fdg3nigta%2F2013%2Fs12705%2F031%2F0283-0283%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdg3nigta%2F2013%2Fs12705%2F031%2F0283-0283%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(一社)日本泌尿器科学会  

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器内視鏡学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Luteinizing hormone (LH) during androgen-deprivation therapy (ADT) with gonadotropin-releasing hormone analogues (GnRHa) has been thought to be biologically inactive, and the regulation of LH during ADT with GnRHa is thus unknown. Insulin-like growth factor-1 (IGF-1) is involved in the regulation of cell proliferation and differentiation, and IGF-1 production in the liver is dependent on growth hormone (GH) secretion from the anterior pituitary. Despite the presence of IGF-1 receptors in the gonadotroph, associations between the GH/IGF-1 and pituitary-gonadal axes, e.g., whether IGF-1 elicits the LH secretion, remain unclear. METHODS: Seventy-one patients with localized prostate cancer, who received ADT with GnRHa, were prospectively studied based on their blood samples before treatment and after ADT for 6 months. We employed highly sensitive assays for measurement of serum testosterone (electrochemiluminescence immunoassay), GH/IGF-1 (radioimmunoassay), adrenocorticotropic hormone (ACTH: immunoradiometric assay), LH (chemiluminescent immunoassay), and dehydroepiandrosterone sulfate (DHEA-S: chemiluminescent enzyme immunoassay). RESULTS: No correlation was noted between the pretreatment LH and IGF-1 levels; after ADT, the serum LH level was closely correlated with the IGF-1 concentration [Spearman's correlation coefficient (rs) = 0.370, P = 0.001]. The serum levels of androgens and gonadotropins reduced following ADT (P < 0.001 in all). The serum IGF-1 level increased (22 ± 6 nmol/L) compared with that at the baseline (19 ± 5 nmol/L) (P < 0.001), but no change was observed in the serum GH concentration between before and after ADT (1.4 ± 2.3 vs. 0.9 ± 0.9 μg/L, respectively, P = 0.691). The serum testosterone level was not correlated with the LH level either before or after ADT. The testosterone and DHEA-S levels after ADT were correlated with ACTH concentration (rs = 0.367, P = 0.002 and rs = 0.354, P = 0.002, respectively). We did not identify any correlations between the serum IGF-1 concentration and Gleason score, PSA value, or androgen levels. CONCLUSIONS: During ADT with GnRHa, IGF-1 possibly promotes LH production, although its role is unclear. Associations among pituitary-gonadal, pituitary-adrenal, and GH/IGF-1 axes represented by IGF-1-mediated LH secretion and ACTH-mediated androgen synthesis are of interest, since both prostate epithelium proliferation and male anabolic activity are involved in these 3 axes. Assessment of oncologic outcomes is warranted for their significance in patients with prostate cancer.

DOI： 10.1016/j.urolonc.2010.11.001

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器科学会  

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器科学会  

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器科学会  

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記述言語：日本語   出版者・発行元：腎移植・血管外科研究会  

腎移植後免疫抑制療法下に発症した免疫性血小板減少症を経験したので報告する。症例は47歳男性、原疾患IgA腎症による慢性腎不全にて生体腎移植を施行した。腎移植2年後肺炎を契機に肉眼的血尿を認めた。翌年、IgA腎症が再発し、扁桃摘出、ステロイドパルス療法にて加療した。翌年、四肢の紫斑の出現と血小板が3000/μlに減少した。骨髄穿刺にて巨核球の増加を認め、諸検査より他の血液疾患を除外した上で免疫性血小板減少症と診断した。ステロイド療法、IVIG、ピロリ菌の除菌療法を施行し、免疫抑制薬は、シクロスポリン(CYA)、ミコフェノール酸モフェチル(MMF)を継続した。入院から13週間後、血小板は増加し7×10^4/μl前後となりその後も再発無く、寛解を維持している。(著者抄録)

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器科学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2011&ichushi_jid=J01175&link_issn=&doc_id=20110328480974&doc_link_id=10.5980%2Fjpnjurol.102.451_2&url=https%3A%2F%2Fdoi.org%2F10.5980%2Fjpnjurol.102.451_2&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

The intracellular androgen metabolism and cell activity in prostate cancer cells with mutated (LNCaP-FGC) or wild-type (VCaP) androgen receptors in the presence of trilostane, an inhibitor of 3β-hydroxysteroid dehydrogenase, were examined. Trilostane suppressed the intracellular production of androstenedione, testosterone, and dihydrotestosterone from dehydroepiandrosterone in LNCaP-FGC cells. In both LNCaP-FGC and VCaP cell types, the prostate-specific antigen (PSA) levels in media were increased by trilostane alone in a concentration-dependent manner. Both cells pretreated with trilostane showed a dose-dependent decrease in PSA production with bicalutamide (P<0.001). Trilostane should be used with particular concern when treating prostate cancer.

DOI： 10.1016/j.canlet.2010.05.015

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: We elucidated the regulatory mechanism of adrenal androgen synthesis and examined the influence of pituitary-adrenal axis activity on prostate specific antigen during androgen deprivation therapy. MATERIALS AND METHODS: A total of 72 patients with localized prostate cancer were prospectively studied based on blood samples before and after androgen deprivation therapy for 6 months. Serum pituitary hormones, androgens and prostate specific antigen were measured using highly sensitive assays. RESULTS: After androgen deprivation therapy serum levels of luteinizing hormone, follicle-stimulating hormone, testosterone, dehydroepiandrosterone sulfate, androstenedione and prostate specific antigen decreased compared with those at the baseline (all values p <0.001). No difference was noted between serum levels before and after androgen deprivation therapy in growth hormone (p = 0.098) and adrenocorticotropic hormone (p = 0.101). Each serum level of luteinizing hormone, follicle-stimulating hormone and growth hormone after androgen deprivation therapy was not correlated with the serum levels of androgens or prostate specific antigen. The serum adrenocorticotropic hormone level after androgen deprivation therapy was correlated with the serum levels of testosterone (p = 0.002), dehydroepiandrosterone sulfate (p = 0.002), androstenedione (p = 0.006) and prostate specific antigen (p <0.001). Serum dehydroepiandrosterone sulfate and androstenedione levels were also correlated with serum prostate specific antigen (p <0.001 and p = 0.002, respectively). CONCLUSIONS: In patients treated with androgen deprivation therapy the pituitary-adrenal axis mediated by adrenocorticotropic hormone has a central role in the regulation of androgen synthesis. Serum adrenocorticotropic hormone and adrenal androgen concentrations were correlated with the posttreatment prostate specific antigen. Adrenocorticotropic hormone mediated androgen synthesis is a potential target for advanced androgen deprivation therapy.

DOI： 10.1016/j.juro.2010.06.115

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Although androgen deprivation therapy (ADT) has a marked impact on the androgen milieu in vivo and outcomes of prostate cancer (PCa), it remains unclear which parameters reflect the androgen milieu during ADT or whether the milieu is associated with PCa aggressiveness. METHODS: Seventy-two patients with localized PCa were prospectively studied based on their blood samples before and after ADT for 6 months. Serum androgens and related values were measured. RESULTS: Before ADT, there was no correlation between the serum prostate-specific antigen (PSA) and androgen levels. After ADT, the serum PSA levels were correlated with each level of serum testosterone, dihydrotestosterone, androstenedione, dehydroepiandrosterone-sulfate (DHEA-S), and 3alpha-diol G (P < 0.010 in all). Before ADT, patients with Gleason score of > or = 8 were likely to have lower serum testosterone levels than those with Gleason score of < or = 6 (P = 0.058). After ADT, conversely, the testosterone levels in patients with Gleason score of > or = 8 appeared to be higher than in those with Gleason score of < or = 6 (P = 0.060). The serum DHEA-S level was correlated with Gleason score before and after ADT (P = 0.050 and P = 0.040, respectively). CONCLUSIONS: The serum PSA levels well reflect the androgen milieu in localized PCa patients receiving ADT, which can be explained by the Saturation Model and disease control. The androgen milieu in men with high Gleason score PCa is probably less affected by conventional ADT than that in men with low score cancer, which was suggested to be associated with adrenal androgen levels.

DOI： 10.1002/pros.21174

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Although androgen deprivation therapy (ADT) has been associated with bone loss in patients with prostate cancer, its mechanism remains unclear. The growth hormone (GH)/insulin-like growth factor-1 (IGF-1)/parathyroid hormone (PTH) axis plays a critical role in bone synthesis, but its activity during ADT is also unknown. METHODS: Seventy-one patients with localized prostate cancer, who received ADT, were prospectively studied based on their bone mineral density (BMD) and blood and urine samples at the baseline and after ADT for 6 months. RESULTS: The IGF-1 level was correlated with BMD before ADT (rs = 0.325, P = 0.007), but such a relationship disappeared after ADT (P = 0.565). Following ADT, the serum IGF-1 level increased compared with that at the baseline (22 +/- 6 nmol/L vs. 19 +/- 5 nmol/L, respectively, P < 0.001). The serum PTH level was reduced after ADT (41 +/- 33 ng/L) compared with the baseline (55 +/- 44 ng/L) (P < 0.001), but no change was observed in the serum GH level (P = 0.691). Bone resorption markers such as blood N-telopeptide (NTx), urinary NTx, calcium, and inorganic phosphorus levels increased after ADT (P < 0.001 in all). The ratio of the IGF-1 level after ADT/before ADT was associated with the ratio of the value after ADT/before ADT of alkaline phosphatase (rs = 0.266, P = 0.025) and calcium (rs = 0.242, P = 0.042). CONCLUSION: Despite the unaffected GH and upregulated bone resorption, the serum IGF-1 level was elevated by ADT. The IGF-1 level was correlated with BMD before ADT, but the relationship was disrupted after ADT. IGF-1 or its receptor in the bone may be functionally inactivated during ADT.

DOI： 10.1002/pros.21047

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.101.415_2

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記述言語：英語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.101.330_2

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Health-related quality-of-life (HRQOL) after a radical prostatectomy (RP) or external beam radiation therapy (EBRT) has not been studied in conjunction with oncological outcomes in relation to disease risk stratification. Moreover, the long-term outcomes of these treatment approaches have not been studied. We retrospectively analyzed oncological outcomes between consecutive patients receiving RP (n=86) and EBRT (n=76) for localized prostate cancer. HRQOL and functional outcomes could be assessed in 62 RP (79%) and 54 EBRT (79%) patients over a 3-year follow-up period (median: 41 months) using the Medical Outcomes Study Short Form-36 (SF-36) and the University of California Los Angeles Prostate Cancer Index (UCLA PCI). The 5-year biochemical progression-free survival did not differ between the RP and EBRT groups for low-risk (74.6% vs. 75.0%, P=0.931) and intermediate-risk (61.3% vs. 71.1%, P=0.691) patients. For high-risk patients, progression-free survival was lower in the RP group (45.1%) than in the EBRT group (79.7%) (P=0.002). The general HRQOL was comparable between the two groups. Regarding functional outcomes, the RP group reported lower scores on urinary function and less urinary bother and sexual bother than the EBRT group (P<0.001, P<0.05 and P<0.001, respectively). With risk stratification, the low- and intermediate-risk patients in the RP group reported poorer urinary function than patients in the EBRT group (P<0.001 for each). The sexual function of the high-risk patients in the EBRT group was better than that of the same risk RP patients (P<0.001). Biochemical recurrence was not associated with the UCLA PCI score in either group. In conclusion, low- to intermediate-risk patients treated with an RP may report relatively decreased urinary function during long-term follow-up. The patient's HRQOL after treatment did not depend on biochemical recurrence.

DOI： 10.1038/aja.2009.10

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.100.243_2

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Natural disasters cause several medical problems for victims, especially for physically challenged people. The great earthquake in the Chuetsu district in Niigata Prefecture that occurred on October 23, 2004 caused serious damage in the disaster area. We investigated the effect of this earthquake on patients managing urination with clean intermittent self-urethral catheterization (CIC) using a questionnaire by mailing. The questionnaire was collected from 86 patients (60 men, 25 women, one sex unknown). The average age was 64.6 years old (males 64.1, females 65.8). By the first week after the earthquake, the patients with urological symptoms made up 3.8% of subjects surveyed. All of the patients had insufficient fluid intake, and did not live in their own homes, or perform CIC at home, for the period of time after the earthquake. During disasters, it is important that we secure CIC patients a living space, where they can perform CIC, with sufficient drinking water.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: We evaluated prostate-specific antigen (PSA) density of the prostatic volume (PSAD) estimated using transrectal ultrasonography (TRUS; TRUS-based PSAD), magnetic resonance imaging (MRI; MRI-based PSAD), and PSA density of the transition zone (TZ) volume (PSATZD) estimated using MRI (MRI-based PSATZD) in the diagnosis of prostate cancer (PCa). METHODS: One hundred and twenty patients, who were suspected to have PCa based on PSA, ranged between 4.1 and 20.0 ng/mL were enrolled in this study. RESULTS: The prostatic volume estimated using TRUS was smaller than the volume estimated using MRI by 11.4% in the patients with PSA levels ranging 4.1-20.0 ng/mL, 7.2% in those 4.1-10.0 ng/mL, and 15.7% in those 10.1-20.0 ng/mL, respectively. PSA levels were correlated with the prostatic volume estimated using TRUS and MRI, and TZ volume estimated using MRI in the patients without PCa; however, the level was not correlated with them in the patients with PCa. The area under the receiver operating characteristic curve of MRI-based PSAD was higher than that of TRUS-based PSAD; however, there was no statistical difference. Stepwise logistic regression analysis for the prediction of PCa by using PSA-related parameters confirmed that MRI-based PSATZD was the most significant predictor in patients with PSA levels in the range of 4.1-20.0 ng/mL (P < 0.001), the range of 4.1-10.0 ng/mL (P = 0.002), and the range of 10.1-20.0 ng/mL (P < 0.001), respectively. CONCLUSIONS: The prostatic volume estimated using TRUS was smaller than the volume estimated using MRI. MRI-based PSATZD is the most significant predictor in the four parameters.

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.97.347_1

CiNii Article

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.96.294_4

CiNii Article

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記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.96.234_1

CiNii Article

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器内視鏡学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2004&ichushi_jid=J04699&link_issn=&doc_id=20040513250011&doc_link_id=%2Fcs5eswle%2F2004%2F001701%2F013%2F0066-0071%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcs5eswle%2F2004%2F001701%2F013%2F0066-0071%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.95.442_4

CiNii Article

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器科学会  

症例は38歳男で,2年9ヶ月前,両側副腎褐色細胞腫に対して副腎切除術を行った.2年4ヶ月前に左腎腫瘍を認め,左腎部分切除術を施行した.病理所見は腎細胞癌で,遺伝子解析ではcodon167番のmissense変異が同定された.8ヶ月前,右腎腫瘍を認めたが,拡張型心筋症に伴う心機能低下のため手術は困難と考え,現在経過観察中である

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2002&ichushi_jid=J01175&link_issn=&doc_id=20021002090008&doc_link_id=110003060635&url=http%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F110003060635&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

記述言語：日本語   出版者・発行元：一般社団法人 日本泌尿器科学会  

DOI： 10.5980/jpnjurol.93.221_1

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器科学会  

4歳男児.先天性の膀胱外反と尿道上裂を主訴とした.生後7日目および5ヵ月目に受けた膀胱閉鎖術は失敗し,外反膀胱は極めて小さく下腹部の瘢痕形成も高度であった.外反膀胱を利用した根治手術は断念し,膀胱を摘出の上Duhamel法によるSigmoid pullthrough型直腸膀胱を形成した.又,両側精巣は触診上正常であったが,膀胱摘出時に精管は認めず,摘出標本にも前立腺,精嚢組織は見られなかった.尿道上裂に対しては,尿道粘膜を切除して左右の陰茎海綿体を寄せ,陰茎腹側の余剰包皮にあけた穴に亀頭を通し,陰茎を覆った.下腹部皮膚の瘢痕に対しては心窩部まで皮下を大きく剥離し,皮膚を寄せて縫合した.術後経過は順調で皮膚縫合もきれいに形成され,術後8ヵ月の経静脈性腎盂造影は正常で,術後1年4ヵ月には排尿,排便をほぼ正常にコントロールできるようになった

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2001&ichushi_jid=J01175&link_issn=&doc_id=20010403220005&doc_link_id=110003089232&url=http%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F110003089232&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

記述言語：日本語   出版者・発行元：医学図書出版(株)  

29歳女,34歳女.ESWL治療後にたまたま妊娠が判明し,出産に至った.2例とも新生児に奇形はなく発育にも問題はなかった.又,結石は自然排石し,水腎症も消失した.衝撃波照射部位や症例によってはESWL治療が可能になる可能性が示唆されたが,依然として妊婦に対するESWL治療は安易に行われるべきではないと考える

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