Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
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Giant Urethral Stone Presenting as a Scrotal Mass and Urethral Fistula

척추 손상 환자에서 고환 종물로 오인된 거대 요도 결석과 요도루

  • Park, Seung Chol (Department of Urology Medicine, Wonkwang University School of Medicine) ;
  • Lee, Jea Whan (Department of Urology Medicine, Wonkwang University School of Medicine) ;
  • Choi, Jeong Woo (Department of Emergency Medicine, Wonkwang University School of Medicine) ;
  • Hwang, Yong (Department of Emergency Medicine, Wonkwang University School of Medicine)
  • 박승철 (원광대학교 의과대학 비뇨기과학교실) ;
  • 이재환 (원광대학교 의과대학 비뇨기과학교실) ;
  • 최정우 (원광대학교 의과대학 응급의학교실) ;
  • 황용 (원광대학교 의과대학 응급의학교실)
  • Received : 2017.07.18
  • Accepted : 2017.12.08
  • Published : 2017.12.31
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Abstract

A urinary calculus in the urethra is rarely seen and usually encountered in men with a urethral stricture or diverticulum. Herein, we report a rare case of a giant calculus in the urethra of a 42-year-old male patient with paraplegia after spinal cord injury due to car accident 20 years ago. A recent urologic consultation from the emergency room was performed since the patient had multidisciplinary symptoms during the day without any urination and presented with urinary difficulties due to hematuria and pain symptoms occurring with a mass in the bottom of the testicles. Abdomen and pelvic computed tomography (CT) was performed to examine the tumor mass, which was found to be absent. In addition, urethral stones were observed in the CT. Cystostomy was performed after the first urethroplasty, and the stone was removed from the urethra. Two weeks later, the patient was subjected to urethrography to remove the Foley catheter. No specific finding in voiding was detected. Giant urethral stones sometime require differentiation from tumor status. Treatment may vary according to size and location, requiring careful examination.

요도 결석은 매우 드믄 질환으로 보고된 증례가 많지 않으며, 대부분 요도 협착이나 요도 게실이 있는 남성에게서 대게 발생한다. 이에 우리는 20년 전 자동차 사고로 인한 척수 손상 후 하반신 마비가 발생한 42세 남성에서 발견된 거대 요로 결석 증례를 보고하고자 한다. 낮 동안에 다원적 증상을 가지고 있고, 고환 밑으로 종물이 만져지며 혈뇨 및 배뇨시 발생하는 통증을 보이면서 최근에는 소변이 전혀 나오지 않는 증상으로 응급실에 내원하여 비뇨기과 협진이 의뢰되었다. 고환 종물의 성상을 확인하기 위해 복부와 골반 컴퓨터 단층 촬영(CT)이 시행되었다. 검사 결과 종양은 관찰되지 않았다. 하지만, 요도 결석이 확인되었다. 우선적으로 요도성형술을 시행하여 방광루를 제거하였으며, 이후 요로 결석은 제거되었다. 2주 후에 요도조형술을 시행하였고 특이사항이 없음을 확인 후 소변줄을 제거하였다. 현재는 배뇨에 대한 특별한 문제는 없는 상태이다. 거대 요도 결석은 때때로 종양과 감별이 필요하며, 크기와 위치에 따라 치료법이 달라질 수 있어 좀 더 면밀한 검사가 필요하다.

Keywords

References

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