【肾移植术后28年输尿管膀胱吻合口形成膀胱结石伴慢性肠线1例报道】。

Q4 Medicine Japanese Journal of Urology Pub Date : 2021-01-01 DOI:10.5980/jpnjurol.112.49
Michikata Hayashida, Akihiro Yano, Takayoshi Fuu, Naoto Tanaka, Kiichi Hagiwara, Shoichi Nagamoto, Kazushige Sakaguchi, Toshikazu Okaneya, Yasuo Ishii, Shinji Urakami
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引用次数: 0

摘要

一位69岁的男性于1991年因不明原因的慢性肾功能衰竭而接受肾移植手术。2012年因移植物功能障碍合并局灶节段性肾小球硬化再次行肾移植手术。第二次肾移植术后,肾功能稳定。2019年,他以严重血尿就诊于泌尿科。膀胱镜检查显示在靠近右侧壁的膀胱穹窿处有2厘米的膀胱结石。因此,我们采用钬激光经尿道碎石术。膀胱结石被压碎,中间有缝合线,表明缝合线是死因。术中我们试图拆除缝线,但不可能。尽管剩余缝合线存在结石形成的风险,但术后6个月未见结石复发。本病例报告输尿管膀胱吻合处膀胱结石,其核心是最初肾移植时使用的可吸收缝合线。应考虑到可吸收缝合线存在发生吻合口结石的可能性,即使在肾移植后很长时间。
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[A CASE REPORT OF VESICAL CALCULUS FORMATION WITH CHROMIC CATGUT AT THE URETEROVESICAL ANASTOMOTIC SITE 28 YEARS AFTER RENAL TRANSPLANTATION].

A 69-year-old man underwent renal transplantation due to chronic renal failure of unknown cause in 1991. Furthermore, in 2012 he again underwent renal transplantation due to renal graft dysfunction with focal segmental glomerulosclerosis. After the second renal transplantation, his renal function has been stable. In 2019, he presented to the urology department with gross hematuria. Cystoscopy revealed a 2 cm vesical calculus at the dome of the bladder near the right lateral wall. Therefore, we performed transurethral lithotripsy using the holumium laser method. The vesical calculus was crushed, revealing a suture at the center, suggesting the suture as the cause. We tried to remove the suture during operation, however, it was impossible. Although the remaining suture posed a risk for calculus development, there has been no recurrence of a calculus for 6 months after the operation. This case reports a vesical calculus at the ureterovesical anastomotic site, wherein the core was an absorbable suture used during the initial renal transplantation. It should be taken into consideration that there is a possibility of anastomotic calculus occurrence with absorbable sutures, even long after renal transplantation.

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来源期刊
Japanese Journal of Urology
Japanese Journal of Urology Medicine-Urology
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