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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/05/31 18:34:06」(JST)

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A suprapubic cystostomy or suprapubic catheter (also known as a vesicostomy or epicystostomy) is a surgically created connection between the urinary bladder and the skin which is used to drain urine from the bladder in individuals with obstruction of normal urinary flow. Urinary flow may be blocked by swelling of the prostate (benign prostatic hypertrophy), traumatic disruption of the urethra, congenital defects of the urinary tract, or by obstructions such as kidney stones passed into the urethra, and cancer. It is also a common treatment used among spinal cord injury patients who are unable or unwilling to use intermittent catheterization to empty the bladder, and cannot otherwise void due to detrusor sphincter dyssynergia.

Initially, a thin tube (catheter) is placed through the skin just above the pubic bone into the bladder, often with the assistance of ultrasound imaging.^[1] This catheter initially remains in place for up to a month while the tissue around it scars and forms a tract (sinus) between the bladder and the body exterior. After the formation of scar tissue is complete, the catheter is replaced periodically in order to help prevent infection

Medical uses

Failed urethral catheter,
Long term usage (if left in urethral long terms catheters can lead to acquired hypospadias and recurrent/chronic UTIs, urinary tract infections).

Contraindications

Need to rule out bladder cancer in cases of clot retention
Lower abdominal incisions with likelihood of adhesions
Pelvic fracture

Complications

UTIs
Blockage
Bladder stones^[2]
Bladder cancer
Bypass track by urine

Society and culture

The suprapubic cystostomy (spelled "cystotomy", without the "s") is a specialty of the fictional physician Stephen Maturin in Patrick O'Brian's twenty-one volume series on the Royal Navy during the Napoleonic era.^[3]

References

^ Jacob, P; Rai, BP; Todd, AW (September 2012). "Suprapubic catheter insertion using an ultrasound-guided technique and literature review.". BJU international 110 (6): 779–84. doi:10.1111/j.1464-410X.2011.10882.x. PMID 22257272.
^ Suzanne C. Smeltzer (2010). Brunner & Suddarth's textbook of medical-surgical nursing. (12th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 1373. ISBN 9780781785891.
^ O'Brian, Patrick (1998). The Hundred Days (Aubrey/Maturin Series). New York: W.W. Norton & Company. p. 47. ISBN 0-393-31979-2.

External links

Cystostomy description
Vesicostomy care of infants and children

UpToDate Contents

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1. 後部尿道弁のマネージメント management of posterior urethral valves
2. 脊髄髄膜瘤（二分脊椎）の尿路合併症 urinary tract complications of myelomeningocele spina bifida

English Journal

Prospective study of the Transurethral Suprapubic endo-Cystostomy (T-SPEC(®)): an 'inside-out' approach to suprapubic catheter insertion.

Flynn BJ1, Larke RJ, Knoll PB, Anderson KM, Siomos VJ, Windsperger AP.
International urology and nephrology.Int Urol Nephrol.2015 Feb;47(2):257-62. doi: 10.1007/s11255-014-0884-x. Epub 2014 Nov 26.
OBJECTIVES: To prospectively evaluate the new medical device Transurethral Suprapubic endo-Cystostomy (T-SPeC(®)), used for suprapubic catheter (SPC) placement via the transurethral (inside-to-out) approach, and examine the 30-day outcomes in the first US series.METHODS: IRB approval was obtained f
PMID 25425440

Free tubularised vesical mucosa graft for congenital stenosis of the urethra in children.

Mouttalib S1, Bouali O2, Abbo O2, Moscovici J2, Galinier P2.
Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie.Prog Urol.2015 Feb;25(2):109-14. doi: 10.1016/j.purol.2014.11.003. Epub 2014 Nov 8.
BACKGROUND: Reconstruction of urethral strictures in children remains a challenge to the pediatric surgeon as these are often related to different rare congenital anomalies with various clinical presentations that endanger renal function and should be repaired in young children. Multiple techniques
PMID 25530285

The robotic appendicovesicostomy and bladder augmentation: the next frontier in robotics, are we there?

Cohen AJ1, Pariser JJ2, Anderson BB2, Pearce SM2, Gundeti MS2.
The Urologic clinics of North America.Urol Clin North Am.2015 Feb;42(1):121-30. doi: 10.1016/j.ucl.2014.09.009. Epub 2014 Oct 12.
There is growing interest in applying robotic-assisted laparoscopic techniques to complex reconstructive pelvic surgery owing to inherent benefits of precision, tissue handling, and articulating instruments for suturing. This review examines preliminary experiences with robotic-assisted laparoscopic
PMID 25455178

Japanese Journal

前部尿道弁・憩室に起因する下部尿路通過障害の3例

寺脇幹,古村眞,金森豊,杉山正彦,鈴木完,小西健一郎,上岡克彦,長谷川雄一,山崎雄一郎,岩中督
日本小児外科学会雑誌 49(5), 1027-1031, 2013
下部尿路閉塞性障害の原因として前部尿道弁・前部尿道憩室が原因となることがある．我々は，3 例の前部尿道弁・前部尿道憩室症例を経験した．症例1：在胎31 週に，胎児診断にて下部尿路閉塞症を指摘された．出生後，左膀胱尿管逆流症および前部尿道弁・憩室と診断，膀胱皮膚瘻を造設後，1 歳時に尿道形成術を施行した．症例2：母親が排尿異常に気付いて，生後9 か月時に受診，前部尿道弁・憩室と診断された．1 歳時に …
NAID 130004624703

尿道憩室内に発生した女子尿道Clear cell adenocarcinomaの1例

上阪裕香,加藤大悟,中井康友 [他]
泌尿器科紀要 57(11), 639-642, 2011-11
… The patient underwent urethrectomy together with resection of the diverticulum tumor and cutaneous vesicostomy. …
NAID 40019073044

陰茎欠損・短腸症を伴った外反のない膀胱腸裂の1例

佐藤かおり,東本恭幸,金田英秀 [他],古屋武史,岩井潤
日本小児外科学会雑誌 45(2), 211-214, 2009-04-20
症例は日齢0の男児.在胎32週3日,胎児心音の低下を認め,緊急帝王切開にて出生.外性器異常・鎖肛を認め,当院搬送入院となった.尿膜管より排尿・排便を認めたが,臍帯ヘルニアなどの合併はなく,下腹部は正常皮膚で覆われていた.陰茎欠損と二分陰嚢を認めるも,精巣は陰嚢内に触知可能であった.尿膜管からの造影では膀胱と腸管が描出され外反のない膀胱腸裂と診断し,緊急手術を施行した.開腹所見では,膀胱後壁が回腸に …
NAID 110007161626

Related Pictures

image vesicostomy for term side of card ; Suprapubic Cystostomy; Vesicostomy Opinions on Suprapubic cystostomy Mitrofanoff The mitrofanoff principle 피부방광루 (Cutaneous Vesicostomy vesicostomy Cutaneous vesicostomy