神経因性膀胱の薬物療法 --利尿筋-尿道外括約筋dyssynergia症例へのTolperisone hydrochlorideの投与の試み--

Abstract

There are many patients with neurogenic bladder who complain of dyssynergia between detrusor and external urethral sphincter. Intra-abdominal pressure. vesical pressure, urethral pressure, tonus and electromyogram of sphincter ani and urine flow rate were determined and recorded simultaneously with a polygraph with six channels. Dyssynergia between detrusor and external urethral sphincter could be clearly confirmed by this method. Tolperisone hydrochloride, a striated muscle relaxant, was administered to the pcltients with neurogenic bladder demonstrating dyssynergia. Urodynamic examinalions were carried out before and after drug administration. In regard to the major symptoms of neurogenic bladder, dysuria and incontinence, it was found that the drug was effective for the former but ineffective for the latter. It was therefore assumed that the combined use of smooth muscle contracting agents with Tolperisone hydrochloride would enhance its effect. The pattern of dyssynergia between detrusor and external urethral sphincter did not return to normal even with administration of Tolperisone hydrochloride.