A New Recording CystometerによるCystometryの研究

Abstract

The recording cystometer deviced by Milam and Leberman was p artly modified by the authors in order to measure the pressure between 0 and 800 mmH20. Introduction of its mechanical structure and performance was attempted (Fig. 1, 2, 2', 3) and the cystometrograms produced by the new cystometer were discussed. 1) Excretory cystometry and retrograde cystometry w ith continuous flow have been done on the normal bladder. If the rate of flow was low the cystometrogram revealed physiological and is closed to excretory cystometry. On the other hand, if the rate of of flow was high MDVP (Pressure of maximum desire to void) became high and diverged from physiological one (Fig. 4a, b). 2) Excretory cystometry in the vesical neurosis produced the intermittent spike waves at each vesical tenesmus simultaneously, while these spike waves were not observed in the retrograde cystometry (Fig. 5a, b). 3) From the above results, excretory cyst o metry is more physiological than retrograde cystometry, and is able to obtain cystometrogram required for diagnosis of bladder dysfunction. 4 ) Furthermore, in vesical neurosis an increase in MDVP and a decrease in bladder volume were observed by parasympathomimetic drug, Besacolin, and a decrease in MDVP and an increase in bladder volume were observed by parasympatholytic drug, Buscopan (Fig. 5b), in excretory cystometry providing a guide of treatment for this disease. 5) Excretory cystometry exhibited atonic bladder in neurogenic bladder due to myogenic disturbance and automatic bladder not producing vesical tenesmus with a suf ficient intravesical pressure in neurogenic bladder due to hemorrhage in the spinal cord (Fig. 6, 7). It also exhibited hypotonic bladder in neurogenic bladder due to amyotrophic lateral sclerosis, in which case an improvement of clinical symptoms was obtained by the use of ATP-preparation (Adenosin triphosphate) which resulted in producing near normal cystometrogram (Fig. Ea, b). 6) Cystometrograms in the ca s es with acute cystitis and bladder tumor were also shown (Fig. 9, 10).