脊損患者の膀胱尿管逆流

Abstract

Clinical studies for five years on the etiolog y and treatment of vesicoureteral reflux in traumatic paraplegics suggest the following conclusions : 1. On the clinical stand point, an emphasis is ma d e that the chief etiologic factor is supposed to be the functional and metabolic disturbances in the musculature of the ureter rather than the anatomical changes at the ureterovesical junction. 2. The principle of the treatment on vesicoureteral r eflux had to be conservative, and the drug treatment which will recover the disturbances of the ureter is expected to be the most important from its pathogenesis. 3. Vanishment of ves i c oureteral reflux is confirmed in five cases by the oral administration of bethanechol chloride (30-75 mg daily) and a-tocopherol (300-450 mg daily). Discovery of the drug which activate and recover the functional and metabolic disturbances of the ureter will bring good progress in conservative treatment of vesicoureteral reflux. 4. Vesicoureteral reflux is harmful to the kidney, but clinically is not always so disastrous. So it had to be considered as a symptom which manifests the functional and organic deterioration of the upper urinary tract. 5. Before the plastic surgery on urete r o vesical junction is done, it is important to ascertain whether the organic changes at the junction is reversible or not.