脊髄損傷の泌尿器科学的研究 第3報: 脊髄損傷患者の膀胱分割レ線撮影成績

Abstract

Cystopolygraphy was made on 51 cases of paraple g ia due to the traumatic injury of the spinal cord and the following results were obtained. 1) The circular, rhombic and flat bladders wer e found in 17 cases (33.3%), 26 cases (51.0%) and 8 cases (15.7%) respectively out of 51 cases examined. The circular bladder was seen most frequently in the supranuclear group, that is, in 10 out of 21 cases (46.6%), while the rhombic bladder was seen most frequently in the infranuclear group, that is, in 19 out of 30 cases (56.7%). 2) Trabecula formation w a s found in 66.7%, prolongation of the vesical apex in 45.1 %, urethra dilatation at the retrocervical region in 56.9% and vesicoureteral reflux in 11.8%. These abnormal contours of the bladders were observed more frequently in the infranuclear group. 3) The ty p ical pine-tree shaped bladder was found in 15 cases (29.4%), that is, in 4 cases of the supranuclear group (19.1%) and in 11 cases of the infranuclear group. (36.7%). 4) There seemed to exist no intimate relationship between the contour and the micturating function of the bladder. 5) As to the localization of the bladder, the right-deviated bladder was far more than the left-deviated, the former being found in 41.2% and the latter in 5.8%. There was no significant difference in the incidence of the bladder deviation between the supranuclear and infranuclear groups. 6) According to Freuden b erg, the lengh of the longest perpendicular lines (RN and LM) drawn from the right and left borders of the bladder to the median line connecting the center of the sacral canar with the pubic symphysis, and the area of the right and left parts of the bladder (ORU and OLU) divided by the above median line were measured, and it was found that RN was almost equal to LM in 58.8% of the circular bladders, while RN was longer than LM in 61.5% of the rhombic bladders, and that ORU was larger than OLU in most cases (76.5%) of the circular, rhombic and flat bladders. 7) In the rhombic and flat bladders, the difference in area between ORU and OLU as well as the deviation of the bladder increased in degree in proportion as the contrast media injected into the bladder increased in volume.