ESWLにより砕石し経尿道的に摘出しえた尿管瘤内結石の1例

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66歳男.排尿困難と排尿終末時痛を主訴とした.腎・尿管・膀胱単純X線造影(KUB)で骨盤腔内に石灰化像を認めた.超音波検査・静脈内点滴腎盂造影(DIP)・CT・膀胱鏡所見も加えて,両側尿管瘤及び右尿管瘤内結石と診断した.結石が大きかったため体外衝撃波粉砕術(ESWL)を行い,経尿道的に尿管瘤切開及び結石摘除術を施行した.術後2年目のKUB,DIPでは,結石の再発を認めなかったA 66-year-old man was referred to our hospital with chief complaints of difficulty in urination and terminal micturition pain. Ureteroceles were identified bilaterally, and a ureteral stone (19 x 12 mm) existed in the right ureterocele. After crushing the stone by extra corporeal shock wave lithotripsy (ESWL), we removed the stone transurethrally with a small incision in the right ureterocele. The vesicoureteral reflux (VUR) was not detected postoperatively. Now, we recommend the combination of ESWL and a small transurethral incision of the urelerocele for the treatment of ureteral stones in a ureterocele in order to prevent postoperative VUR.