第6巻 2010年6月　第3号

■症例から学ぶ

腹腔鏡下手術を施行した膀胱子宮内膜症―診断と治療のポイント
峯　克也¹, 明樂　重夫¹, 近藤　幸尋², 竹下　俊行^1
1日本医科大学大学院医学研究科女性生殖発達病態学
²日本医科大学大学院医学研究科外科治療学（泌尿器外科学）

Laparoscopic Surgery for Bladder Endometriosis: A Case Report
Katsuya Mine¹, Shigeo Akira¹, Yukihiro Kondo² and Toshiyuki Takeshita^1
1)Division of Reproductive Medicine, Perinatology and Gynecologic Oncology, Graduate School of Medicine, Nippon Medical School
²⁾Department of Urologic Surgery, Graduate School of Medicine, Nippon Medical School

A 33-year-old woman was referred to us by the department of urology because of cyclic bladder pain during menstruation. Cystoscopy showed a 3.5-cm-diameter tumor in the bladder mucosa, and a biopsy showed chronic cystitis. Transvaginal ultrasound and pelvic magnetic resonance imaging revealed a left endometrial ovarian cyst. Although a biopsy did not prove bladder endometriosis, we diagnosed bladder endometriosis on the basis of the characteristic clinical findings. Laparoscopic partial cystectomy for bladder endometriosis and left ovarian endometrial cyst resection were performed. The bladder was closed in one layer using Z sutures with #3-0 polyglactin 910. Indigo carmine dye was then used to check for any leakage. The procedure lasted 4 hours, and the estimated blood loss was 10 mL. There were no technique problems or complications. The Foley catheter was removed after 7 days. The symptoms had resolved by 4 weeks after surgery, and the patient was released to routine follow-up. The patient had complete resolution of bladder symptoms and cyclic pelvic pain and was delighted with the absence of pain and the cosmetic result.

日医大医会誌 2010; 6(3), 147-151

Key words
bladder endometriosis, laparoscopic surgery, laparoscopic partial cystectomy

Correspondence to
Katsuya Mine, Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku Tokyo 113-8603, Japan
E-mail：s2085@nms.ac.jp

受付：2010年3月8日　受理：2010年4月20日