二分脊髄症に伴う泌尿器科的合併症とその処置に関する検討

概要

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During the 10 years from January, 1965 to June 1976, 45 patients (24 males and 21 females) were treated at the Department of Urology, Niigata University Hospital for any urological complications of spina bifida. There were 6 cases of spina bifida occulta and 39 cases of spina bifida cystica (meningocele and myelomeningocele). The ages on the first visiting ranged from 0 years to 24 years, with an average of 6.2 years. Urological examinations revealed following abnormalities: Vesicoureteral reflux in 33% of the cases, hydronephosis (38%), residual urine (62%), urinary tract infection (65%), abnormal cystogram (95%), urine incontinence (98%), abnormal cystometrogram (100%), negative anal tonus (43%) and absence of bulbocavernosus reflex (65%). Relatively conservative treatments were recommended. Crede bladder expression was beneficial both in reducing the amount of residual urine and in treating urinary tract infection. Indwelling urethral catlleter drainage was also useful in preventing upper urinary tract deterioration. When these managements were found not enough effective, surgical procedures (cutaneous vesicostomy, ileal conduit, colocystoplasty, or Y-V plasty of the bladder neck) were indicated.
社団法人日本泌尿器科学会の論文