糖尿病性膀胱機能障害の2例

Abstract

This report presents two cases of diabetic neurogenic b l a dder dysfunction treated successfully by transurethral resection of the vesical neck. Case 1. A woman, aged 45 years, was admitte d on May 2, 1955, because of diabetes. Her presenting complaint was inability to urinate. It was found that she has a distended bladder which could be felt above the pubis ; on catheterization, 2, 000 cc of urine were withdrawn. Her diabetic condition was complicated by diabetic retinopathy and peripheral neuropathy. Neurological examination revealed diminution of vibratory sence of the legs and absent knee and ankle jerks. The cystometrogram showed a distended atonic bladder with no emptying contractions. Transurethral r esection of the posterior lip of the bladder neck was done on July 7, 1955. The immediate postoperative course was good, and two months following surgery the residual urine was found to be 60 cc. Case 2. A man, aged 48 years, was admitted on October 13, 1959, complaining of difficulty in voiding and nocturia. He was found to have a marked glycosuria. The residual urine amounted to 400 cc. Neurological examination demonstrated absent knee and ankle jerks. Urological examination revealed a atonic bladder with a capacity of 90D cc. On January 20, 1960, the posterior lip of the bladder neck was resected. Si x months following surgery the residual urine was found to be 30 cc.