球海綿体反射の臨床的研究 -逆行性尿道抵抗と尿道外括約筋筋電図の同時測定-

Abstract

1. Simultaneous recording of retrograde urethral resistance (RUR) and electromyography (EMG) of the external urethral sphincter was carried out in 30 patients with chronic persistent neurogenic bladder caused by the spinal cord injury. It was confirmed that change of the curve in both examinations was developed simultaneously at the time of bulbo-cavernous reflex (BCR) procedure in 20 cases. BCR-RUR is more simple to measure and more easy to analyse deta than BCR-EMG. However BCR-EMG is more sensitive for presentation of BCR than BCR-RUR. 2. Pudendal nerve block and pudendal neurectomy were performed in patients with cord bladder in whom the acceleration of BCR was regarded as a main cause of dysuria. The average value of BCR-RUR fell from 37 mmHg to 10 mmHg in II of 12 cases after pudendal nerve block. Improvement of dysuria and decrease of BCR-RUR were obtained in 8 of II cases of unilateral neurectomy and in all 4 cases of bilateral neurectomy. The pudendal neurectomy may be recommended when transurethral resection of the bladder neck or the urethral sphincter is not effective enough for treatment of dysuria.