著者

若月 晶

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.51, no.11, pp.737-740, 2005-11

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2001年1月から3年間に受診した亀頭包皮炎189例を,化膿連鎖球菌を分離した47例(PYO群),他の細菌を分離した93例(B群),細菌の検出がない27例(NB群),不必要のため細菌検査をしない22例(N群)に分け,臨床像と感染経路を比較検討した.その結果,PYO群は他の3群に比べて,臨床症状の膿性分泌及び疼痛,症状出現前の性的接触が多く,潜伏期間及び発症から受診までの期間が短い傾向が見られた.PYO群では包茎のない症例を7例認めた.更に,2004年1月から1年間に化膿連鎖球菌による亀頭包皮炎11例に対してamoxicillinを使用した結果,全例で治癒が確認されたBetween January 2001 and December 2003, 189 adult patients with balanoposthitis were treated in my clinic. Swab culture from the affected lesion detected Streptococcus pyogens in 47 cases (PYO group), other bacterial species including Candida albicans in 93 (B group), no bacterial growth in 27 (NB group) and swab culture was not done because clinical symptom was trivial in 22 (N group). The PYO group had a significantly higher prevalence of purulent discharge (68.1%) and local pain (38.3%), compared to the B group (25.8% and 21.5%, respectively) or the NB group (33.3% and 11.1%, respectively). Phimosis was absent in 7 cases in the PYO group. The route of infection in the PYO group was considered to be predominantly via sexual contact (PYO group 78.7%, B group 52.7%, NB group 59.3%), especially through fellatio by commercial sex worker for the majority of the PYO patients. The latent period (from sexual contact to the onset of symptoms) was 3 days or less in 40.5% and 4 to 7 days in 35.1% in the PYO group, whereas it was more than a week or not remembered in the majority of the B and NB groups, disapproving the causal relationship with sexual contact in such cases. Treatment with tosufloxacin tosilate or amoxicillin was effective in most cases of streptococcal balanoposthitis. Our results suggest that Streptococcus pyogens is one of the causative organisms of sexually transmitted balanoposthitis.

著者

若月 晶 辻畑 正雄 三宅 修 伊東 博 板谷 宏彬 宇高 不可思

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.39, no.10, pp.891-897, 1993-10

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1)進行性核上性麻痺7例の膀胱尿道機能の検査の結果,蓄尿期では6例が過活動性膀胱で尿意の低下が見られた。コンプライアンスは良好であったが3例で膀胱容量が低下していた。2)排尿期では4例が低活動性膀胱で1例が無収縮であった。括約筋筋電図は1例で収縮筋括約筋協調障害3例で活動の低下がなく1例で無抑制弛緩がみられた。3)尿失禁の原因は神経学的には蓄尿期の過活動性膀胱と考えられたが痴呆とADLの障害も重要であった。残尿は排尿期の低活動性膀胱と括約筋の活動異常のいずれかあるいは両者が原因と考えられた。4)治療としてはαブロッカーがやや有効な症例もあったが,痴呆とADLの障害も大きな問題であり,排尿ベルの使用が尿失禁の看護には有効であったWe performed a vesicourethral function study on seven patients with progressive supranuclear palsy. In storage phase, 6 patients had decreased urinary sensation and overactive detrusor. Although bladder compliance was normal in all patients, maximum cystometric capacity was decreased in 3 patients. In micturition phase, detrusor contraction was underactive in 4 patients and acontractile in 1 patient. Sphincter electromyogram showed detrusor-sphincter-dyssynergia in 1 patient, no decrease in 3 patients and synergistic decrease in 1 patient. Six patients had urinary incontinence partially due to those neurological abnormality, partially due to dementia and lower activity of daily living. To facilitate the care of such functional incontinence, we devised a urinary alarm. The urinary alarm is a device to detect urine in a diaper. One can know the micturition in a diaper without being informed of micturition by the patient and change diapers as soon as possible. It was also useful to examine their frequency/volume chart.