透視併用尿時連続撮影による排尿機構の研究

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By voiding urethrocystography (combined with fluoroscopy) under the use of "spot" film, the author made researches in the movements of the bladder base and posterior urethra during the course of micturition about 35 normal cases and 115 pathologic cases. The method is as follows : the patient was given 4-6 exposures in one film at 45 degrees obliclue and standing position during the act of micturition. (In case of neurogenic bladder, at the antero-posterior and supine position.) 15% sodium iodide or double diluted sugiuron was used as the contrast medium, and retrogradely injected into the bladder with a rubber catheter. 1) The contrast medium, which was injected into the bladder, was controlled at the level of the internal or external sphincter except more than half of neurogenic bladder and each case of prostatic cancer, tuberculosis, prostatitis and prostatic hypertrophy. And after prostatectomy, it was generally coritrolled at the level of the external sphincter. Therefore, as the closing mechanism of the urethra, the internal sphincter and the external sphincter are discrinainated: Especially the function of the external sphincter is regarded to be the more important in the control of micturition. 2) At the beginning of micturition, the bladder base descends in most cases and scends in a few cases, and the internal orifice descends in all cases who can void. From the active phase of micturition till the terminal phase, the bladder base ascends in all cases having no or a little residual urine, but in one case of chronic cystitis, it is observed to descend. 3) At the active phase of micturition, the normal width at the level of the intertal orifice is 6-1.5 mm, and that at the level of the external sphincter is more than 3 mm. The width varies accordjng to the kind of disease. 4) In order to find out the correlation of the dilating function of the posterior urethra, the author calculated the rate of dilation (the rate of the level of the internal orifice to that of the external sphincter, the supracollicular portion and the level of vermontanum), and then the mechanism of micturition could be objectively observed. 5) In case of voiding urethrocystography , the reflux of the contrast medium was observed in higher rate than in retrograde urethrocystography. 6) The external sphincter takes a great part in the mechanism of voluntary interruption of micturition. 7) For the examination of the dilating function of the posterior urethra, voiding urethrocystography is the most suitable, and the direct exposule is very valuable in clinical diagnosis, because the change of forms can be observed in detail by it.
社団法人日本泌尿器科学会の論文

透視併用尿時連続撮影による排尿機構の研究

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