潜在性神経因性膀胱

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There is a group of cases who show the clinical features of obstructive uropathy but neither anatomical obstruction nor neurological disorder. After introduction of urodynamic examinations to the lower urinary tract, this subclinical or occult neurogenic bladder dysfunction is frequently detected not only in the patients with severe obstructive lesions, but also in the patients with recurrent urinary tract infection and/or slight urination disorders. 1. Consideration for possible neurological lesions : The age distribution chart of subclinical neurogenic bladder cases is very similar to that of neurogenically evident bladder dysfunction cases. The cases of neurogenic bladder clearly show the peculiar variety and incidence in each generation. Therefore, when the diagnosis of subclinical neurogenic bladder is made, it should be asked first of all whether the thorough neurological examinations have been made to find the causal diseases. 2. Subdivision of vesico-urethral dysfunctions and the possible site of neurological lesions: Even in the same group of patients with the same neurological disease, such as meningomyelocele or cerebrovascular lesion, the urodynamic features are variable, and the nature of their vesico-urethral dysfunctions could be subdivided based on detrusor and sphincter reflex activities, detrusor-sphincter coordination, and voiding cystourethrographic pattern. However, these proceedings of classification do not necessarily simplify the complicated problem , "the decision of the site of neurological lesions''. 3. Uninhibited bladder : The age distribution chart of all the cases with uninhibited bladder contraction shows the characteristic curve of parabola, in which the overwhelming majority of the cases are distributed in young children. Contrary to the high incidence of mechanical obstruction or organic disease in old patients, most of these children can not be proven to have any neurological defect, though organic urethral stenosis, including Lyon's Ring, is detected in less than half of them.
社団法人日本泌尿器科学会の論文

潜在性神経因性膀胱

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