放射線療法による尿路障害
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概要
- 論文の詳細を見る
The authors report cases of radiation injuries of the urinary tract and its surgical treatments during the last fifteen years. The cases are as follows: teleangiectasia 13 cases ulceration with ureteral obstruction 2 cases vesicovaginal fistula 7 cases vesicorectovaginal fistula 4 cases contracted urinary bladder 3 cases 1) Case of teleangiectasia in the bladder were detected averagely 6 years after radiation therapies for uterine carcinoma or bladder tumor (Fig. 1, 2, 3). The symptom was painless hematuria occasionally with blood tamponade. The most useful treatment was transurethral electrocoagulation. 2) Ulceration occurred from the implantation of radon seeds for bladder tumor. One case was followed by spontaneous healing after 21 months (Fig. 4). The other case was mistaken for recurrence of the tumor and resulted in cystectomy (Fig. 5, 6). 3) We present here the most interesting case in plastic operation for vesicorectovaginal fistula. A 54-year-old woman, suffering from carcinoma of the cervix received radiation of intracavitary radium and x-ray in an excessive dose. Before long, this resulted in a hen's egg sized vesicovaginal fistula and a walnut sized rectovaginal fistula. The success of a plastic operation could not be expected because of excessively fibrosed tissues. One of the authors, Tsuchiya, tried a new method. Namely, the fibrosed uterus was pulled down and cut open. A half of the uterus was utilized as a support for bladder sutures and the other half was applied to close the rectovaginal fistula (Fig. 7). This method brought a satisfactory result. The bladder capacity after the operation was 200 ml. 4) Ileocystoplasty was carried out for two cases of a contracted bladder. In one case, the function of the plastic bladder was not so good as we had expected. The cause of this unsatisfactory result was due to the fibrosed urethra.
- 社団法人日本泌尿器科学会の論文
著者
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宮村 隆三
宮村医院
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豊田 泰
都立広尾
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黒土 稔
川崎新川橋
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三浦 桝也
東京逓信
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土屋 文雄
東京逓信病院泌尿器科
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中川 完二
東京逓信病院泌尿器科
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豊田 泰
東京逓信病院泌尿器科
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宮村 隆三
東京逓信病院泌尿器科
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三浦 桝也
東京逓信病院泌尿器科
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黒土 稔
東京逓信病院泌尿器科
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