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特集 神経因性膀胱
文献概要
要旨 骨盤内悪性腫瘍根治術後の核下型神経因性膀胱は，制癌が得られても下部尿路機能障害による生活の質の低下が生じ，患者にとって大きな問題である。特に，非可逆的神経因性膀胱症例においては尿路合併症を回避するために，尿流動態検査による病態把握とこれに基づく排尿管理法を決定することが望ましい。また，神経因性膀胱のスクリーニングや経過観察としては残尿測定のみでなく妥当性のある症状質問票などの使用はもちろん，尿流測定も併せて評価する必要がある。排尿管理法としての腹圧排尿や間欠導尿の利害得失に対する理解も必須である。医原性神経因性膀胱である性質上，予防が最重要であり，自律神経温存の適応がある場合には根治性を損なうことなくていねいかつ確実な神経温存手術を行えることが腫瘍外科系医師の必須条件である。
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