개에서 발생한 뇨 저류에 의한 전립선 결석의 치료

Treatment of Prostatic Calculus Causing Urinary Retention in a Dog

  • Park, Chul-Ho (College of Veterinary Medicine, Chonnam National University) ;
  • Oh, Ki-Seok (College of Veterinary Medicine, Chonnam National University) ;
  • Son, Chang-Ho (College of Veterinary Medicine, Chonnam National University)
  • 심사 : 2013.12.09
  • 발행 : 2013.12.31

초록

과거 방광결석으로 진단되어 처방식으로 관리 중인 6살의 잡종견이 혈뇨 증상을 주증으로 전남대학교 동물병원에 내원하였다. 환축은 복부 방사선 검사 결과 전립선 위치에 결석이 확인되었고, 초음파 검사와 CT 검사 결과 전립선 내 결석이 전립선 요도 내강으로 돌출되어 있음을 확인하였다. 환축은 prostatolithotomy를 통해 전립선 내 결석을 제거한 후 찢어진 전립선 요도를 봉합하였고, 결석에 의한 전립선 내강은 omentum을 채워 넣은 후 봉합하였다. 결석의 성분 분석을 위해 crystallographic analysis를 시행한 결과 결석은 magnesium ammonium phosphate (struvite) 80%와 carbonate apatite 20%로 구성되어 있음을 확인하였다. 환축은 수술 후 회복하여 뇨의 누출은 관찰되지 않았고, 혈뇨 증상은 개선되었으며, 수술 후 6개월에도 특별한 임상증상은 없었다.

A cross breed dog (6-year-old, 6 kg, intact male) was referred with hematuria. The dog had been treated for years owing to the urinary bladder calculi. On abdominal radiography, prostatic calculus was demonstrated in the prostatic area. In addition, ultrasonography and computed tomography (CT) scan would confirm that the part of calculus protruded within the prostatic urethra. The patient underwent a prostatolithotomy and traumatic prostatic urethra was carefully sutured and the omentum was filled with the prostate lumen. A crystallographic analysis of the stone showed 80% magnesium ammonium phosphate (struvite) and 20% carbonate apatite. The leakage of the urine was not observed post-operation and the hematuria improved and there was no specific problem at the 6 months follow-up.

키워드

참고문헌

  1. Bedir S, Kilciler M, Akay O, Erdemir F, Avci A, Özgök Y. Endoscopic treament of multiple prostatic calculi causing urinary retention. Int J Urol 2005; 12: 693-695. https://doi.org/10.1111/j.1442-2042.2005.01133.x
  2. Blacklock N. Prostatitis. In: Textbook of genitourinary surgery, 2nd ed. London, United Kingdom: Blackwell Science. 1998: 633-641.
  3. Hasegawa M, Ohara R, Kanao K, Nakajima Y. Transurethral lithotripsy with holmium-YAG laser of a large exogenous prostatic calculus. Urol Res 2011; 39: 153-155. https://doi.org/10.1007/s00240-010-0323-0
  4. Kamai T, Toma T, Kano H, Ishiwata D. Urethral obstruction due to protruding prostatic calculi. J Urol 1999; 162: 163-164. https://doi.org/10.1097/00005392-199907000-00044
  5. Klimas R, Bennett B, Gardner WA Jr. Prostatic calculi: a review. Prostate 1985; 7: 91-96. https://doi.org/10.1002/pros.2990070110
  6. Lumb WV. Prostatic calculi in a dog. J Am Vet Med Assoc 1952; 121: 14-16.
  7. Smith J. Canine prostatic disease: A review of anatomy, pathology, diagnosis, and treatment. Theriogenology 2008; 70: 375-383. https://doi.org/10.1016/j.theriogenology.2008.04.039
  8. Sutor DJ and Wooley SE. The crystalline composition of prostatic calculi. Br J Urol 1974; 46: 533-535. https://doi.org/10.1111/j.1464-410X.1974.tb03852.x