Sekido N, Hinotsu S, Kawai K, Akaza H, Koiso K
Department of Urology, Tsukuba Gakuen Hospital.
Nihon Hinyokika Gakkai Zasshi. 1995 Jun;86(6):1177-80. doi: 10.5980/jpnjurol1989.86.1177.
The patient was a 68-year-old woman, who had underwent radical hysterectomy and postoperative radiation therapy thirteen years ago, and suffered from typical symptoms of panperitonitis in 1992 and 1993. Based upon laboratory findings of ascites, intraperitoneal urinary extravasation was suspected as the cause of panperitonitis. However, IVP, cystography, cystoscopy could not show the direct evidence of extravasation. On urodynamic study, poor flow rate, large postvoided residual urine, disturbance of the bladder sensation, and low compliance were present. We considered the neurogenic bladder dysfunction and detrusor weakness due to the previous radical hysterectomy and radiation therapy as the possible causal factors of spontaneous bladder rupture causing urinary extravasation from the bladder in this case.
患者为一名68岁女性，13年前接受了根治性子宫切除术及术后放射治疗，1992年和1993年出现典型的全腹膜炎症状。根据腹水的实验室检查结果，怀疑腹膜内尿液外渗是全腹膜炎的病因。然而，静脉肾盂造影、膀胱造影、膀胱镜检查均未显示外渗的直接证据。尿动力学研究显示，存在尿流率差、排尿后残余尿量多、膀胱感觉障碍及顺应性降低。我们认为，既往根治性子宫切除术和放射治疗导致的神经源性膀胱功能障碍和逼尿肌无力可能是本例自发性膀胱破裂导致膀胱尿液外渗的病因。
