著者

長浜 克志 山田 拓己 一柳 暢孝 酒井 康之 鎌田 成芳 福田 博志 谷沢 晶子 渡辺 徹 斉藤 博 堀内 晋 町田 竜也

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.48, no.1, pp.1-6, 2002-01

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Hautmann型膀胱再建術中,癌死・他因死・追跡不能を除く20例(男16例・女4例,29~73歳)を対象に,術後の回腸新膀胱の蓄尿・排尿状態を尿流動態検査(UDS)とアンケート調査により解析した.排尿回数は夜間に2回以上起床し排尿している例が19例中8例と高率であった.また,尿失禁は19例中昼間2例,就寝後12例にみられたが昼間は尿パッド平均2枚,夜間は1枚で対処可能であった.排尿時間は18例中9例が1分以内に排尿を終えたが3例では3分以上を要した.排尿状態については18例中満足8例,不満3例であった.USDを施行できたのは11例で観察期間は平均34.2±21.9ヵ月であった.残尿量は27.8±28.2ml,新膀胱最大容量は395.2±96.8mlで膀胱内圧は充分に低値であった.排尿時,外尿道括約筋筋電図で明らかな電位増強を11例中10例と高率に認めたWe analyzed the functional and urodynamic characteristics in 19 patients with ileal neobladder by the Hautmann procedure. A questionnaire survey by mail was performed for functional information of neobladder. Seventeen of the 19 patients (89.5%) could voluntarily void via the urethra and the others needed clean intermittent self catheterization (CIC) because of their significant residual volume. Eight of the 19 patients (42.1%) micturated at least two times at night. Two of the 19 patients (10.5%) were incontinent in the day time and 12 (63.2%) in the night time. They needed 2 pads in the day time and one pad at night on average. Eight out of 18 patients (44.4%) were satisfied with their micturition state. A urodynamic study showed the neobladder to be a low-pressure reservoir with a mean capacity of 395.2 +/- 96.8 ml. The mean residual volume of the patients without CIC was 27.8 +/- 28.2 ml. In 10 out of 11 patients high frequency and high amplitude spikes were seen by the perineal electromyogram in the voiding phase.