A Case of Extramammary Paget's Disease with Urethral Invasion Treated by Construction of Continent Urinary Diversion Based on the Monti Principle Using the Sigmoid Colon

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  • Hakariya, Tomoaki
    The Department of Urology, Nagasaki University Graduate School of Biomedical Sciences
  • Nakanishi, Hiromi
    The Department of Urology, Nagasaki University Graduate School of Biomedical Sciences
  • Asai, Akihiro
    The Department of Urology, Nagasaki University Graduate School of Biomedical Sciences
  • Kanokoki, Katsura
    The Department of Urology, Nagasaki University Graduate School of Biomedical Sciences
  • Kihara, Toshiharu
    The Department of Urology, Nagasaki University Graduate School of Biomedical Sciences
  • Takehara, Kosuke
    The Department of Urology, Nagasaki University Graduate School of Biomedical Sciences
  • Igawa, Tsukasa
    The Department of Urology, Nagasaki University Graduate School of Biomedical Sciences
  • Sakai, Hideki
    The Department of Urology, Nagasaki University Graduate School of Biomedical Sciences
  • Tou, Kazuo
    The Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences
  • Takeshita, Hiroaki
    The Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences
  • Miura, Kiyonori
    The Division of Gynecology, Nagasaki University Graduate School of Biomedical Sciences
  • Tanaka, Katsumi
    The Department of Plastic and Reconstructive Surgery, Nagasaki University Graduate School of Biomedical Sciences
  • Kashima, Shiro
    The Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences
  • Matsuo, Manabu
    The Department of Urology, Nagasaki Prefecture Shimabara Hospital

Bibliographic Information

Other Title
  • S状結腸を利用しMonti 変法による非失禁型導尿路を作成した尿道浸潤を有する乳房外Paget 病の1例
  • Sジョウ ケッチョウ オ リヨウ シ Monti ヘンポウ ニ ヨル ヒシッキンガタドウニョウロ オ サクセイ シタ ニョウドウ シンジュン オ ユウスル チブサ ガイ Pagetビョウ ノ 1レイ

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Abstract

Extramammary Paget's disease occurring in the female vulva is occasionally associated with invasive disease to urethra and bladder mucosa. For such cases, ensuring adequate surgical margin is essential. Not only adequate removal of tumor, but also urinary diversion is important for patient's quality of life. A 77- year-old woman was treated with excision of vulvar tumor, urethra, vagina, rectum and anus. The determination of excision area was decided according to the result of mapping biopsy including urethra and bladder. Then she received reconstruction of vulva using the gracilis muscle skin flap. We applied a technique of channel formation for intermittent catheterization using the retubularized sigmoid colon based on the Monti principle. The tube was implanted submucosally into the bladder to prevent the reflux of urine. Fifteen days after operation, self-intermittent catheterization was started successfully. Surgical margins were negative in urethra, skin, vagina and rectum. There are no obvious recurrence or metastasis 1 year after surgery.

Journal

  • Hinyokika Kiyo

    Hinyokika Kiyo 61 (2), 61-65, 2015-02

    泌尿器科紀要刊行会

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