鎖肛に合併した泌尿器系病変および術後合併症の治療について

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Treatment of the urologic anomalies associate with anorectal malformation and urologic complications after surgery for various anorectal malformations are discussed. Thirty six patients with major urologic anomalies were found among 228 patients with imperforate anus. Urologic anomalies included undescended testis in 12 cases, hypospadia in 8, phimosis in 3, renal dysplasia in 6, hydroureter in 6, vesicoureteric reflux (VUR) in 12 and so on. Orchiopexy was done in 8 patients at the age of 8 months to 9 years. Two patients with hypospadias were operated on when they were 4 years old. Nephrectomy was performed in 3 patients for unilateral dysgenesis of the kidney with hydroureter at the age of 2 months to 6 years. Antireflux operation was done in 3 patients with VUR when they were between 3 and 6 years old. VUR disappeared spontaneously after the anoplasty in 5 patients under 2 years old. Postoperative complications were counted in 14 patients. Operative treatment was performed in 8 patients. One re-opening of rectourethral fistula was treated by Soave's opetration. Three urethral injuries were cured by simply suturing of the urethra and indwelling of Foley catheter. Postoperative urinary incontinence in a patient with cloacal type was treated with the construction of ileal conduit. Two urethral strictures were treated with vesicostomy and urethral bougienage. One urethral diverticulum was resected and repaired. Eight patients with neurogenic bladder (NB) were treated with vesicostomy or urethral catheterization. All of these patients with NB recovered from urinary disturbance within 7 years.
1991-04-20

鎖肛に合併した泌尿器系病変および術後合併症の治療について

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