前立腺肥大症に關する研究 第1篇:前立腺肥大症の統計的観察

Abstract

大正4年1月より昭和26年12月迄の37年間に, 京大附属病院泌尿器科を訪れた470例の前立腺肥大症患老の臨床的統計的観察を行い, 既に本症に就て諸家の報告する所と略々一致した結果を得たが, その成績は次の如くであつた.1)頻度:大正4年1月より昭和10年3月末までの21年間に於ける皮膚科泌尿器科外来患者実数に対する本症患者の年度別百分率は0・034～0・533%にして平均0, 126%であつた.又昭和10年4月1日より昭和26年12月末までの16年9ケ月間に於ける泌尿器科外来患者実数に対する本症患老の年度別百分率はO.79～3.35%にして平均1・94%であつた・2)年令的関係:初診時年令は最弱年が43才, 最老年が92才にして61～70才が最も多く, 発病時年令に於ても同様である・3)職業:無職の者最も多く次で農業・商業の順である・4)既往症:特に本症と関係ありと考えられる疾患はないが, 嘗て淋疾に罹患せるものが57。3%の多きに及んでいる・5)発病より初診までの期間:発病当日のものから30年の長期に亘るもの迄あつて全く種々であるが, 1ケ年以内のものが約半数それ以上のものが約半数となつている.6)季節的関係:10月, 9月の秋に最も多く次で6月に多い・7)主訴:尿意頻数最も多く次で排尿困難, 尿閉の順である, 8)合併症:膀胱結石最も多く次で膀胱炎, 尿道狭窄の順である・9)残尿:150c・c・以下のものが過半数を占めている.10>腎臓機能:インジゴカルミン及びフェノールズルフオンフタレイン排泄試験にて約20%が著萌に障碍されている.11)直腸内触診所見:前立腺の性状は弾力性硬, 表面平滑にして圧痛無く、鶏卵大までのものが大部分を占めている・12)膀胱鏡所見:全葉とも腫大せるもの最も多く, 次で左右両葉の腫大せるものが多い・又殆んど全例に於て多少とも肉柱形成を認める・

1. Clinical Statistical Study of Benign Prostatic Hyperplasia The total of 470 patients with benign prostatic hyperplasia, all of whom were examined at the Urological Clinic, Kyoto University during the 37 years. from 1915 to 1951, were reviewed in this paper. 1. Frequency : The per centage of patients with benign prostatic hyperplasia to total out patients that visited the Department of Urology and Dermatology in one year ranged from 0.034-0.553% during 21 years from January 1915 to March 1935, and their average was 0.126% for one year. During 16 years and 9 months from April 1935 to December 1951, the per sentage of the patients with benign prostatic hyperplasia as compared to the total number of the out patients that visited the Department of Urology in one year ranged from 0.79 to 3.35% and their average was 1.94% for one year. 2. Age : The age of patients at the first examination ranged from 43 to 92 years old and it was observed that the majority of patients with benign prostatic hyperplasia that visited for the first examination were in the sixth decade of life and the onset of symptoms in total patients was most frequently in the same decade. 3. Occupation: Of the total patients 31.4 % were retired, 25.2% were farmers and 18.2% were business-men. 4. Medical History: No correlation was recognized between the benign prostatic hyperplasia and any other kind of previous disease. However, the history of gonorrhoea was seen in 53.7% of total patients. 5. Period from the onset of symptoms to the initial examination: This period was highly variable, varying from 1day to 30 years, and approximately half of the total patients visited the physician with one year after the onset of symptoms. 6. Seasonal Relationship for Initial Examination: The largest number of initial examination occured with peaks appearing in September - October, and next highest in May-June. 7. Chief Complaints: The most common complaints were urinary frequency (48.8%), dysuria (33.4%) and total urinary retention (26.8%). 8. Complications: The bladder calculus was most often observed, and the next was cystitis and urethral stricture. 9. Residual Urine: 54.7% of total patients had less than150cc. of residual urine. 10. Renal Function; The excretion test by the use of Indigocarmine and PSP test showed distinctly low function in about 20 percent of all patients, 11. Rectal Examination: The quality of the prostate glands in most of patients was elastic hard, smooth surface, without pain by the pressure and estimated to be smaller than the hen-egg size. 12. Cystoscopic Findings: Most of ten observed was the swelling in all lobes of the prostategland, and next was the swelling of both later all obes. It was also observed that almost all patients had the trabecular formation in the urinary bladder wall.