女子尿道疾患知見補遺 第1編: 膀胱頸部炎について

Abstract

1. On the cystitis colli. 1) Statistical stu d y on the bladder neck inflammation of the female for the past five years at our department was performed. Eighty per cent of the examinees were the menstruants. 2) Histological examination of the urethra was carried out using 70 fresh, female adult which were free from the genitourinary disordors and 3 female fetal cadavers with special interests on the leukoplakia of the bladder neck and the glandular structures, which were considered as important dispositions causing cystitis colli. It became apparent that the clinically so-called leukoplakia was the insels of the stratified squamous epithelium containing glycogen and was found in all the cases. The glandular structures were mostly present in the termi n al half of the urethra, but were found around the neck in 16% of the cases. Lymphocytes and blood vesseles were abundantly present in all the examples. 3) The urethral and the Vaginal smear showed similar hormonal circular changes. 4) Follicular, hormone added urethral suppository revealed remarkable the r apeutic effects on the bladder neck inflammation clinically. This fact was also proved by the ureth r al smear examination. 5) From the above-mentioned observations it b e c ame apparent that some of the so-called cystitis colli are caused by hormonal disorders and the rich presence of the glandular structures, lymphocytes and the blood vesseles are the important predispositions for the occurrence of inflammation. 6) Cystitis colli is liable to recur. Destruction and cicatrization of the inflammed epithelium by the electrocoagulation and the chemical corrosive are the treatment of choice. 2. On the stress incontinence. 1) Stress incont i n ence may occur in the female of any ages. It was found in more than half of the examinees in the child' and the aged. Stress incontinence was also found in high percentage in the female of the age 30 s. 2) Stress incontinence was found in about 30% of the nulliparae and the incidence elevated as the number of the delivery increased. Eleven cases of the multiparae (over 6), all complained of stress incontinece. 3) The persons of the delayed menophania are prone to show high incidence of the stress incontinence. 4) L aughing, cough and sneezing were important contributing factors. Stress incontinence occurs in high incidence in the latter part of the pregnancy. 5) Interruption of urination was impossible in the majority of the female. 6) By histological examination of the female urethral muscular st r u ctures, it was found that the striated muscle fibers of the sphincter did not form a complete circular ring around the urethra. Accordingly the posterior wall of the urethra plays an important role in occurrence of the stress incontinence in cooperation with the presence of the vagina beneath it. 7) As the causes of t he stress incontinence in the child, hypoplasia of the muscular and the mucosal tissues, in the middle age, overextension of the external sphinctor and in the old, atrophy and relaxation of the muscles may be considered. 8) The results of the sphinctometry, which showed 's i gnificant difference between the persons complaining of the habitual stress incontinence and the normal female were presented. 9) Two succesfully treated cases were presented.