弛緩性膀胱に対するZoedler手術の改良法について

Abstract

Atonic bladder along with chronic urinary retention is fre q uently accompanied with longstanding lower urinary tract obstruction or neurogenic bladder dysfunction. In such cases, treatment for the causal disease alone is not effective in reducing the residual urine volume and is frequently unable to result in normal miction. For this reasons, various operative procedures for the bladder have been reported in order to solute the problems, and, in generally, resection of excessive bladder wall by Orr is widely performed for such cases. In 1964, Zoedler described an improved procedure for reduction of inside space of the bladder without resection of its wall. This is performed with partial decollement of the mucosal membrane from the muscular layer followed by reinforcement of the bladder wall with piling one muscle layer on another. The Zoedler's procedure was further improved in our case of 61 years old male with atonic bladder who was performed to eliminate the mechanical obstruction followed by improved method of Zoedler's operation with transverse incision of the bladder wall. The result was satisfactory.