直腸癌手術後の膀胱尿管損傷に対し,回腸利用膀胱拡大術を施行した1例

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A 65-year-old man underwent transperineal drainage of pelvic abscess after rectal amputation for rectal cancer. The bladder wall and right ureter were injured during this operation, which led to vesicoperineal fistula and contracted bladder. We performed partial resection of the bladder (fistulectomy), augmentation ileocystoplasty (Cup-patch technique), and bilateral ureteral reimplantation (LeDuc-Camey technique). After surgery, the patient was able to void without any residual urine or incontinence. There was no hydronephrosis or resicoureteral reflux postoperatively. Augmentation cystoplasty is usually performed to treat a contracted bladder, but it can also be applied for the reconstruction of complicated lower urinary tract injury, and may improve the quality of life (QOL) dramatically.