成人男子に認められた尿膜管開存症の1例

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症例は31歳で,生下時に臍部の突出が認められ尿様の漿液漏出が観察されたが,2週間で消失した.22歳時より再度臍から尿の漏出があり,放置していたところ約6年で消失した.7ヵ月前の健診で膿尿を認め,そのさい施行された腹部超音波検査で尿膜管の遺残が疑われたため,今回精査目的で自施設を受診した.各種画像所見より右腎臓と右精巣の欠損を伴った尿膜管開存症と診断し,膀胱頂部と尿膜管の摘出術を行ったA 31-year-old man was referred to our hospital for evaluation of urachal rest. The history of his present illness dated back to birth, when the umbilicus was projected and urinary discharge was noted. At that time, the symptom of discharge had spontaneously subsided. At the age of 22, however, the patient again experienced discharge from the umbilicus. Although he did not seek treatment, after six years this symptom disappeared. Around this time, however, pyuria was revealed during medical examination, and abdominal ultrasonography (US) suggested the presence of urachal rest. At the time of hospitalization, physical examination revealed that the patient's right testis was not palpable. He was diagnosed with patent urachus with hemilateral aplasia and monorchism by US, computed tomography, magnetic resonance imaging and cystoscopy. The patient subsequently underwent radical operation. Patent urachus in adults is very rare, and only a few cases have been reported. To our knowledge, only one previously reported case involved a recurrence after spontaneous healing. Further, this is the first report of a patient with patent urachus with hemilateral aplasia and monorchism. Radical operation is generally recommended, based on the fact that very few cases heal conservatively.

成人男子に認められた尿膜管開存症の1例

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