排尿時斜傾位連続レ線間接撮影法による排尿開始時の膀胱運動の研究 第2報:排尿困難者の場合

Abstract

On 12 cases of hypertrophy of the prostate, one case of megalo- b ladder (atonic bladder) and 7 cases of other types of dysuria were studied. In hypertrophy of the prostate where a marked o r ganic change at the bladder neck is found, nothing essentially different in micturition movement from normal can be seen but retardation. On the other hand, in functional dysuria where organic lesion is not found the essential movements of the bladder in micturition, descends of the bladder base and increase in the bladder axis, are deficient either in both or in one. In some ca s es of dysuria it is recognized that the bladder base contract well while the other parts of the bladder do not, in other words, the bladder muscles as a whole do not act coordinatingly for smooth micturition. The voluntary intravesical pressure here is not elevated also. Pilocarpine, when subcutaneously inj e c ted, increases the tonus of the bladder and intravesical pressure, but it makes few the cystograms to change from before. Micturition does not get ease. In other words, pilocarpine does not favour the micturition movement of the bladder itself. With reference to the literature a n d from my results it is concluded that the internal urethral orifice opens in micturition actively by its selfstanding movement. The reflex of are voiding is not set into function in dysuria or is delayed. The bladder base or bladder neck may play a very important role as an initial point for setting this reflex into function. Meatotomy and increase of the bladder content favour micturition, as they incite this reflex arc to function. Details would be reff e red to Nagoya Medical J. Vol. 3. No. 4, 1955.