排尿障害の水力学的研究 - 前立腺肥大症および神経因性膀胱の排尿時膀胱内圧,尿流量および最低尿道抵抗について -

Abstract

The voiding pressures (P) and the urinary flow rates (F) were simultaneously measured and the minimum urethral resistances during micturition were obtained according to the Ohm's law (R=P/F) in 36 cases of benign prostatic hyperplasia and 30 cases of neurogenic bladder (cord bladder). The results were as follows. 1. Benign prostatic hyperplasia. 1) The dysuria was classified into 7 types according to the values measured before treatment and it was also classified into 4 types according to the clinical course, namely period of pre compensation, period of compensation, period of uncompensation and period of urinary retention. 2) The clinical effect of Eviprostat was judged by this method and a little improvement was noticed in some cases. 3) Transurethral resection of prostate (TURP). a) A close relationship was noticed between R and the width of bladder neck obtained by urethro-cystography after TURP or the subjective symptoms. b) No certain relationship was found between R and the weight of tissue removed at. TURP or the amount of residual urine. c) The results of measurements after TURP are strongly influenced by inflammation of the urethra and bladder. 2. Neurogenic bladder. 1) The neurogenic bladder examined was classified into the following 3 types according to the voiding methods. Type I: Hand pressure and abdominal pressure. Type II: Hand pressure, abdominal pressure and reflex. Type III: Reflex. 2) The relation of P, F and R in the respective types were as follows. Type I: Both P and R were high, F was relatively large and the voiding efficiency was good. Type II: Both P and R were high and F was small. The amount of residual urine was large and the voiding efficiency was the worst. Type III: Both P and R were low and F was very small. The amount of residual urine was the largest. The voiding efficiency was bad. 3. This method is significant in judging the effect of treatment and choice of therapy in benign prostatic hyperplasia and neurogenic bladder.