前立腺摘除術におけるVURの検討

Abstract

The cystography or voiding cystourethrography in pre- and post-prostatectomy period was performed to study the role of surgical injury at the trigone and urinary tract infection in the causation of reflux. The results obtained were as follows: 1) No reflux was observed under anesthesia and immediately after operations using cystography. 2) On the first postoperative day, reflux was observed in 7 of the 19 patients (36.8 per cent), being bilateral in 5 cases. In 5 cases the degree of reflux was grade I, and in 2 cases it was grade II. 3) On the seventh postoperative day, 3 patients were found to have reflux; being unilateral in all cases. On the fourteenth postoperative day, only one patient showed reflux. But this patient had showed reflux in the preoperative study. 4) On the first postoperative day, 9 patients showed WBC more than 20 per high power field on urinalysis and 6 of them (66.7 per cent) demonstrated reflux. On the seventh postoperative day, 10 patients showed a similar urinalysis finding and 3 of them demonstrated reflux. The demonstration of the postoperative reflux is concluded that urinary tract infection, especially severe inflammation, may facilitate the development of reflux as additional factor causing more prominent dysfunction of the ureterovesical junction in addition to the open prostatic surgery.