男子高齢者の排尿障害に関する研究 第2報: 下部尿路閉塞性疾患および神経因性膀胱患者の尿流量曲線の波型に関する検討

Abstract

下部尿路閉塞性疾患および神経因性膀胱の尿流量曲線の波型を6型に分け, 尿流量率, 排尿量, 残尿量について検討した.1)前立腺肥大症, 前立腺癌, 尿道狭窄ではobstructive diseases (OB)型がもっとも多かった.膀胱頸部硬化症でもOB型がもっとも多かったが, anterior peak (AP)型の頻度が, 33.3%と上記3疾患より多く認められた.2)波型別の尿流量率は, normal (N)型・Postirior peak (PP)型が良好で, AP型・others (OT)型・OB型・neurogenic bladder (NB)型の順に低値を示していた.3)下部尿路閉塞性疾患における, 波型と排尿量, 残尿量の関係は, N型・PP型は排尿量が多く残尿量が少ない.AP型・OT型は100 ml以上の排尿量と50 ml未満の残尿量を示す例が多いが, OB型は100 ml未満の排尿量と50 ml以上の残尿量を認める例が多かった.NB型は, 排尿量, 残尿量とも少なかった.4)神経因性膀胱における波型は, NB型が51.7%と過半数を占めており, 神経因性膀胱に特徴的であった

Uroflowmetry was examined in 192 patients with obstructive urinary symptoms. They were 173 males with obstructive diseases in lower urinary tract (302 uroflowmetric studies) and 19 males with neurogenic bladder (29 uroflowmetric studies). We classified the patterns of uroflowmetric curve into 6 types: N type (normal), NB type (neurogenic bladder: wave like curve), OB type (obstructive diseases: flat curve), AP type (anterior peak), PP type (posterior peak) and OT type (others). The 331 uroflowmetric curves were classified into the above 6 types, and the relationship between each type of flow curve and other uroflowmetric parameters (voided volume = VV, residual urine volume = RU, maximum flow rate = MFR, average flow rate = AFR) was analyzed. The types of 229 flow studies (140 patients) in benign prostatic hypertrophy were OB (77.7%), AP (16.6%), OT (3.9%), N (0.9%) and PP (0.9%). The types of 39 flow studies (25 patients) in prostatic cancer and 13 studies (8 patients) in urethral stricture were similar; 92.3% of the flow studies being classified into OB type. The types of 21 flow studies (10 patients) in so-called bladder neck contraction were OB (42.9%), AP (33.3%), OT (14.3%) and NB (9.5%). AP type flow curves were more frequent than other in obstructive diseases.(ABSTRACT TRUNCATED AT 250 WORDS)