尿道下裂術後の尿道発毛に対する経尿道的レーザー脱毛  [in Japanese] LASER HAIR REMOVAL FOR URETHRAL HAIR AFTER HYPOSP ADIAS REPAIR  [in Japanese]

症例は56歳,男性.陰茎腹側の硬結を主訴に来院した.1歳時と2歳時に尿道下裂に対して尿道形成術を施行された既往があった.5年前と2年前に尿道結石に対して尿道切石術を施行されていた.尿道結石再発と診断し,尿道切石術を施行した.結石には尿道から発生した多数の毛が含まれており,形成尿道からの発毛が結石形成の原因と考えられた.結石再発の予防目的に除毛剤の尿道内注入を行ったが除毛効果がみられなかったため,半導体レーザーを用いて経尿道的レーザー脱毛を行った.術後5ヵ月で再発毛を1本認めるのみであり,ほぼ完全な脱毛が得られている.尿道発毛は皮膚弁を用いた尿道形成術後にみられる晩期合併症であり,結石形成や尿路感染の原因となる.経尿道的レーザー脱毛は,尿道発毛に対して有用な低侵襲治療と考えられた.

A 56-year-old male was admitted for induration of ventral side of the penile shaft. Computed tomography showed a large urethral calculus in the distal urethra. About 50 years previously, he had undergone multi-staged urethroplasty for hypospadias. He had also suffered from recurrent urethral calculi managed by urethrolithotomy 5 and 2 years before the admission. Urethrolithotomy revealed hair-bearing urethral calculus. Instillation of depilating agent containing thioglycolate into the neourethra for preventing hair regrowth was ineffective. Transurethral laser hair removal of neourethra was subsequently performed. All the neourethral follicles were ablated with GaAlAs diode laser (wave length 810nm; at a power of 15W for 2 seconds) through a side-firing laser fiber. Another three operations were performed for a few regrown hairs at a power of 20-30W. Convalescence was uneventful. The patient is free of hair regrowth except for a hair at five months of follow-up.