過去10年間における膀胱頚部硬化症の臨床的観察

Abstract

Clinical observations of 74 patients with bladder neck contracture who had been examined in the past 10 years were made. 1) Bladder neck contracture was found only in 0.3% of outpatients and during the past 5 years 19 cases (25.7%) were examined. 2) Yanase's method of roentgenological visualization of the vesical neck was used commonly for the purpose of diagnosis, and voiding cystourethrography, endoscopy, and urodynamic studies followed this. 3) The vesical neck of 40 operated cases was examined histologically. Muscular hyperplasia was observed in 18 cases, inflammation in 12 cases, fibrosis in 3 cases, mixed findings in 3 cases, and insufficient samples in 4 cases. 4) Bladder neck contracture with prostatic adenoma was found after the age of 60 years and its histological findings presented mainly muscular hyperplasia. According to Marion's theory, diagnosis of these cases must be made as benign prostatic hyperplasia. 5) In 14 cases of bladder neck contracture with normal prostatic tissue, inflammatory change of the vesical neck was found in 11 cases, muscular hyperplasia only in 3 cases. Therefore we reason that chronic inflammation play a role in the pathogenesis of bladder neck contracture.