排尿困難症のレ線学的鑑別診断 : 特に膀胱内バルーン牽引による膀胱頸部抽出法

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1. Measurement of the diameter of the vesical neck and posterior urethra, at the portion of verumontanum in voiding cystourethrography was made for the differential diagnosis of dysuria. The results are as follows ;2. The author devised a new roentgenological method to show the shape of the bladder neck. A soft baloon tied to the tip of an urethral catheter was inserted into the bladder. The balloon was filled with 20 ml of contrast medium, and the end of urethral catheter was tracted by a 250 g weight. The author divides the form of the balloon at the portion of the vesical neck into two types. Type I; the curve of the balloon at the bladder neck is inward convex. This type is subdivided into I-a and I-b according to the degree of convexity. Type II; the curve is outward convex. In a group of 15 cases without dysuria 9 cases belonged to type II and the other 6 cases to type I-b. However, in the 22 cases with dysuria, 21 cases belonged to type I and 14 of them belonged to type I-a. We think that the roentgenollogical finding of the bladder neck by this method may be as useful for judging the condition of the bladder neck as the test of finger-insertion into the posterior urethra during suprapubic operation. Though our experience is still limited, this new method is useful in differential diagnosis and an indication for operation of bladder neck obstruction.
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