新生児・乳児期の尿閉症例の検討

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Acute urinary retention in newborns and infants is uncommon. We presented 12 cases of urinary retention with palpably distended bladder whom we treated during the last 14 years. The etiologic disorders included 7 posterior urethral valves and 2 bladder diverticula. Another three cases consisted of an ectopic ureterocele, a hydrometrocolpos and functional vesical dysfunction in a newborn associated with intestinal hypoperistalsis. In about half of the cases, urinary tract infection seemed to be the predisposing factor to acute retention. In general, patients with the worse degree of obstruction present the symptom at the earlier times, occasionally even in the newborn period. Two cases have been diagnosed by the prenatal ultrasonography. The reliable methods to demonstrate underlying causing disorders are micturition cystourethrography and ultrasonography. In patients with bladder diverticula, the extent of the diverticulum during voiding together with the existence of reflux must be monitored under fluoroscopic control. Although temporary vesical drainage through a small urethral catheter is an effective treatment, a diversion of the upper urinary tract is mandatory in cases with prolonged urinary tract infection or poor recovery of the renal function. Follow-up studies of patients revealed impaired renal function in 6 (5 with posterior urethra lvalve and one with ureterocele). Urinary incontinence continued in patients with posterior urethral valve and urogenital sinus anomaly, and it has become the main problem after they reached the school age.
日本小児外科学会の論文
1989-08-20

新生児・乳児期の尿閉症例の検討

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