女性頸髄損傷患者に対する膀胱皮膚瘻(Cutaneous vesicostomy)の長期成績

概要

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膀胱皮膚瘻で尿路管理中の女性頸髄損傷患者5例の長期成績について検討した.全例で,上部尿路は正常に保たれており,自律神経過反射は消失した.患者のQOLも改善し,手術に対する満足度も高かった.女性頸髄損傷患者において,膀胱皮膚瘻は有用な尿路管理法であると考えられたTetraplegic women who underwent a cutaneous vesicostomy in our institutions were studied to evaluate long-term urinary complications and their quality of life (QOL). A total of 5 patients (C4, C5 and C6 injuries in one patient each and C7 injury in 2) were followed for 98 to 125 months (mean 107 months). Autonomic hyperreflexia disappeared after surgery in all patients. None of the patients showed deterioration of the upper urinary tract. Urinary tract infections were noted in 3 of 5 patients, but not severe. Bladder stones developed in 2 patients and a stomal stricture in 1. A questionnaire survey showed the patients to be satisfied with the operation, which had improved their QOL. These findings suggest that a cutaneous vesicostomy is an excellent surgical procedure for tetraplegic women.