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Title: 進行性核上性麻痺とパーキンソン病での膀胱尿道機能の比較検討
Other Titles: Comparison of the vesicourethral function between progressive supranuclear palsy and Parkinson's disease
Authors: 若月, 晶  KAKEN_name
辻畑, 正雄  KAKEN_name
三宅, 修  KAKEN_name
伊東, 博  KAKEN_name
板谷, 宏彬  KAKEN_name
宇高, 不可思  KAKEN_name
Author's alias: Wakatsuki, Akira
Tsujihata, Masao
Miyake, Osamu
Ito, Hiroshi
Itatani, Hiroaki
Udaka, Fukashi
Keywords: Progressive supranuclear palsy
Parkinson's disease
Urinary incontinence
Vesicourethral function
Neurogenic bladder
Issue Date: Jun-1993
Publisher: 泌尿器科紀要刊行会
Journal title: 泌尿器科紀要
Volume: 39
Issue: 6
Start page: 523
End page: 528
Abstract: 1)PSPでは6例で蓄尿期の収縮筋反射亢進のために尿失禁を生じていたが,4例では排尿期の括約筋の活動異常あるいは膀胱収縮の低下のために残尿が認められた。PAでは蓄尿期の収縮筋反射亢進が主体で切迫性尿失禁を呈し,残尿を伴うような排尿障害は認めなかった。2)PSPではPAとは異なり,尿意が低下し排尿障害を伴っていたことと,高頻度に痴呆とADLの低下を伴っていたことが尿失禁の治療を困難にしていた。3)膀胱容量が低下して切迫性の尿失禁を示したPAでは抗コリン薬や三環系抗鬱薬が有効であったが,PSPでは排尿障害に対してαブロッカーが有効なものが2例あったが排尿症状の薬物治療は困難であり,尿意の低下や痴呆による機能性の尿失禁の看護に対して排尿ベルが有用であった
We compared the vesicourethral function between progressive supranuclear palsy (7 cases) and Parkinson's disease (vesicourethral function study in 8 patients with dysuria and questionnaire study in 44 patients). The frequency of urinary incontinence in the 44 patients with Parkinson's disease was 38.7%. Vesicourethral function study showed hypersensitivity, low bladder capacity, detrusor hyperreflexia and normal sphincter EMG. The frequency of urinary incontinence in supranuclear palsy was 85.7%. Vesicourethral function study showed hyposensitivity and detrusor hyperreflexia in 6 cases, and 4 of these 6 cases had residual urine due to impaired detrusor contraction in micturition phase and/or abnormal sphincter EMG. Compliance was normal, but bladder capacity was decreased in progressive cases. Impaired contraction and hyposensitivity made it more difficult to control the urinary incontinence in supranuclear palsy than in Parkinson's disease. Dementia and lower ADL were frequently accompanied with supranuclear palsy (rare in Parkinson's disease). These were other factors that worsen the control of incontinence.
URI: http://hdl.handle.net/2433/117867
PubMed ID: 8337978
Appears in Collections:Vol.39 No.6

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