Hagiwara Noriyasu, Nishida Yasuyuki, Fujimoto Yoshinori, Isogai Kazutoshi, Fujihiro Shigeru, Deguchi Takashi
Department of Urology, Ogaki Municipal Hospital.
Hinyokika Kiyo. 2002 Jun;48(6):367-70.
The patient was a 44-year-old woman, who had undergone radical hysterectomy and postoperative radiation therapy for cervical cancer at the age of 34 years old. In 1998, she was admitted to our hospital with chief complaints of acute abdominal pain and high fever. We made a diagnosis of spontaneous bladder rupture associated with neurogenic bladder dysfunction and radiation cystitis, based on findings of cystoscopy and cystography. She was cured by conservative therapy, including catheter drainage and antibacterial chemotherapy. Thereafter, she was managed with intermittent self-catheterization. In 2000, spontaneous bladder rupture recurred, but conservative therapy was effective again. A review of 12 cases of recurrent spontaneous bladder rupture in Japan, including the present case, suggests that proper management of urination for neurogenic bladder dysfunction may be necessary for prevention of recurrent rupture, when the impaired bladder is left after either successful conservative or surgical treatment of bladder rupture. Urinary diversion and augmentation cystoplasty should be considered for repeated rupture of the bladder.
该患者为一名44岁女性,34岁时因宫颈癌接受了根治性子宫切除术及术后放疗。1998年,她因急性腹痛和高热为主诉入住我院。根据膀胱镜检查和膀胱造影的结果,我们诊断为与神经源性膀胱功能障碍和放射性膀胱炎相关的自发性膀胱破裂。她通过包括导管引流和抗菌化疗在内的保守治疗得以治愈。此后,她接受间歇性自我导尿管理。2000年,自发性膀胱破裂复发,但保守治疗再次有效。对包括本病例在内的日本12例复发性自发性膀胱破裂病例的回顾表明,当膀胱破裂经成功保守或手术治疗后仍存在膀胱功能受损时,对神经源性膀胱功能障碍进行适当的排尿管理可能是预防复发性破裂所必需的。对于膀胱反复破裂,应考虑尿流改道和膀胱扩大成形术。