title: [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].
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.
authors: The Department of Urology, Nagasaki University Graduate School of Biomedical Sciences.
authors: Tomoaki
authors: T
authors: Hakariya
authors: The Department of Urology, Nagasaki University Graduate School of Biomedical Sciences.
authors: Hiromi
authors: H
authors: Nakanishi
authors: The Department of Urology, Nagasaki University Graduate School of Biomedical Sciences.
authors: Akihiro
authors: A
authors: Asai
authors: The Department of Urology, Nagasaki University Graduate School of Biomedical Sciences.
authors: Katsura
authors: K
authors: Kanokoki
authors: The Department of Urology, Nagasaki University Graduate School of Biomedical Sciences.
authors: Toshiharu
authors: T
authors: Kihara
authors: The Department of Urology, Nagasaki University Graduate School of Biomedical Sciences.
authors: Kosuke
authors: K
authors: Takehara
authors: The Department of Urology, Nagasaki University Graduate School of Biomedical Sciences.
authors: Tsukasa
authors: T
authors: Igawa
authors: The Department of Urology, Nagasaki University Graduate School of Biomedical Sciences.
authors: Hideki
authors: H
authors: Sakai
authors: The Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences.
authors: Kazuo
authors: K
authors: Tou
authors: The Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences.
authors: Hiroaki
authors: H
authors: Takeshita
authors: The Division of Gynecology, Nagasaki University Graduate School of Biomedical Sciences.
authors: Kiyonori
authors: K
authors: Miura
authors: The Department of Plastic and Reconstructive Surgery, Nagasaki University Graduate School of Biomedical Sciences.
authors: Katsumi
authors: K
authors: Tanaka
authors: The Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences.
authors: Shiro
authors: S
authors: Kashima
authors: The Department of Urology, Nagasaki Prefecture Shimabara Hospital.
authors: Manabu
authors: M
authors: Matsuo
mesh_terms: D000368:Aged; D012809:Colon, Sigmoid / Q000601:surgery*; D005260:Female; D006801:Humans; D009361:Neoplasm Invasiveness; D010145:Paget Disease, Extramammary / Q000473:pathology / Q000601:surgery*; D014521:Urethra / Q000473:pathology* / Q000601:surgery; D014547:Urinary Diversion / Q000379:methods*; D014846:Vulvar Neoplasms / Q000473:pathology / Q000601:surgery*