橋出血に合併した膀胱頸部閉塞の2例

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58歳男,55歳男.両例とも橋出血発症後6ヵ月して尿閉となった.尿力学的検査で両例とも排尿機能障害と膀胱頸部閉塞を認め,1例では排尿筋外尿道括約筋協調不全があった.眼球運動異常として前者で両側方視と上方の制限,後者で左眼外転障害があった.MRIでは橋被蓋部に広範囲の低信号域(ヘモジデリン沈着)を認めた.経尿道的前立腺切除術/切開術を実施した.術後,自排尿可能となったTwo male patients presented with urinary retention 6 and 8 months after a stroke. On urodynamic investigation, both had impaired detrusor function and bladder neck obstruction, and 1 had unrelaxing distal urethral sphincter. Abnormalities of ocular movement were present. Magnetic resonance imaging revealed a widespread lesion of the dorsal tegmentum of the pons. Transurethral resection and incision of the prostate enabled them to void without significant residual urine. Pontine hemorrhage may cause neurogenic vesicourethral dysfunction because the pontine micturition center is located in the dorsolateral tegmentum of the rostral pons.