Myelodysplasia による先天性神経因性膀胱に対する保存的尿路管理法の成績

概要

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Fiftythree patients with congenital neurogenic vesical dysfunction due to myelodysplasia who have been seen at the Hokkaido University Hospital from October 1959 to December 1980, were subjected for an analysis of the clinical, urographic change and urodynamic findings. In 12 children who were initially examined at the age less than 6 months, intravenous pyelogram was normal. In 7 of those who had undergone cystourethrography there was no ureteral reflux. The follow-up studies (5 months to 21 years) were available in 37 patients. Excepting 6 cases who had been seen before the advent of current conservative regimen, 31 patients have been managed either by Crede alone (17 pts) or clean intermittent self-catheterization (14 pts). These 31 patients showed no signs of clinical or urographic deterioration, but rather marked improvement. Significant renal deterioration was noted onty in 2 patients who belonged to our old seriese and had undergone hasty urinary diversion long time previously. Of various urodynamic parameters, the electromyographic sphincter dyssynergia to carrelate best with voiding dysfunction, since it was absent in the group of patients who had been managed naturally by Crede voiding while it was present in those who could empty the bladder with the aid of clean intermittent self-catheterization.
日本小児外科学会の論文
1982-06-20