Kawamura S, Kumasaka K, Noro K, Aoki H, Kubo T, Abe T
Department of Urology, School of Medicine, Iwate Medical University.
Hinyokika Kiyo. 1991 Sep;37(9):1049-52.
The patient was a 49-year-old male. He had a history of asymptomatic hematuria that had occurred 3 years previously. The hematuria and pollakisuria developed again from about March, 1989, and he was hospitalized for bladder tamponade in April. Bilateral percutaneous nephrostomies were performed because a contracted bladder and bilateral hydronephrosis were detected. He was then admitted to our hospital on June 21. The cause of the contracted bladder was not evident, despite extensive examination. A replacement ileocystoplasty constructed by Shishido's method was used to replace the contracted bladder. A U-shape pouch was prepared by detubularization of 25 cm of the ileum and this pouch was anastomosed to the incised end of the bladder neck after subtotal cystectomy. The ureter and ileum were then anastomosed using Coffey's method. The bladder capacity and the maximum urinary flow rate after 1 year were 350 ml and 13 ml/sec, respectively, and residual urine was not noted after urination even following abdominal pressure. Urinary incontinence was not noted either.
患者为一名49岁男性。他有3年前出现无症状血尿的病史。血尿和尿频自1989年3月左右再次出现，4月因膀胱填塞住院。因发现膀胱挛缩和双侧肾积水，进行了双侧经皮肾造瘘术。然后他于6月21日入住我院。尽管进行了广泛检查，膀胱挛缩的原因仍不明确。采用志道法构建的回肠膀胱扩大术来替代挛缩的膀胱。通过将25 cm的回肠去管化制备一个U形袋，并在膀胱次全切除术后将该袋与膀胱颈的切开端吻合。然后使用科菲法将输尿管与回肠吻合。1年后膀胱容量和最大尿流率分别为350 ml和13 ml/秒，即使腹部加压排尿后也未发现残余尿。也未发现尿失禁。
