外傷性脊髄損傷患者の泌尿器科学的研究 第II報: 膀胱内圧及び尿道抵抗と,それらに及ぼす薬物の影響について

Abstract

Measurement of intravesical pressure was performed in 4 3 patients with traumatic spinal cord injury. At the same time, investigation on the method of measurement, experiments of urethral resistance and studies on effects of autonomic nerve drugs upon these values were examined. 1) According to the results of retrograde contineous measurement of the intravesical pressure, the cases were classified into 1 hypotonic, 18 autonomic, 15 automatic and 9 mixed types. 2) With the method of my own, the urethral resistence was measured and the results were analysed in relation to the intravesical pressure, the maximum voluntary pressure and the residual urine volume. It was found that much more volume of residual urine and lowered bladder efficiency are demonstrated when the urethral resistence is higher than or even equal to the maximum voluntary pressure. 3) Effects of subcutaneously injec t e d drugs upon the intravesical pressure, maximum voluntary pressure, capacity of the bladder and urethral resistence were examined. With Besacoline injection, an increase in the intravesical pressure and a decrease in the capacity of the bladder were found. The maximum voluntary pressure showed slight decrease and the urethral resistence become unchanged or decreased. With Atropin injection, though the curve of t h e intravesical pressure showed invariable figure, a slight increase in the capacity of the bladder, a somewhat decrease in the maximum voluntary pressure and no change or a little increase in the urethral resistence were demonstrated. With Epirenamin injection, the intravesical pressure showed a decrease with an altration of the pressure curve until occasional occurrence of hypertonic situations, but the effects were rather slight in all instances. The maximum voluntary pressure remained unchanged and the urethral resistence showed an increase. With Wintermin injection, no noticea b le change was seen in the figure of the intravesical pressure curve while a trend of decrease in the capacity of the bladder and a slight decrease in the maximum voluntary pressure were demonstrated.