小児における下部尿路のレ線学的研究

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By delayed cystography in 76 cases, voiding cystography in 19 cases and urethrocystography in 88 cases, the author made a morphological observation on the normal case and many urological diseases, especially enuresis. By delayed cystography, the vesicoureteral reflux (VUR) was minutely observed, and incidentally the cystogram was also examined. The rate of the occurrence of VUR is 11.9%, and it is very high in case of the infection of the urinary tract. VUR appears in three types : the immediate type, the continual type and the delayed type. There is no relation between VUR and residual urine, cystoscoplc and cystometric findings. As compared with intravenous pyelogram, the rate of functional decrease of the upper urinary tract is 1/3 on the side showing VUR. By the continuous observation of cystograms in the coursc of time, which shows the proccss of physiological filling of the urinary bladder, the situation of the bladder floor is constant, and the cystogram, which is semilunar and semicircular when the bladder is empty, is most remarkably dilated to the vertical direction, and as a whole it is radiately dilated. The ratio of vertical and horizontal dilation is within 1.2-1.5 for an hour, and as long as the patient doesn't feel a desire to void, the maximum of vertical diameter is not longer than that of horizontal one. The more the age advances, the more the situation of the whole cystogram descends. Both the funnel projection of the bladder neck which was observed by delayed cystography and the dilation of the bladder neck and the internal orifice by voiding cystography are the characteristic findings in case of enuresis. As a result of the observation which was made from the view point of the aging in measuring many urethral portions of the male infants and children by urethrocystography, the prostatic urethra does not grow so remarkably in childhood, but rapidly develops since puberty. And yet the other portions grow nearly in proportion to the development of total constitution. The supracollicular portion is classified into four types by urethrocystography, and among them the dilated type was often found in enuresis. By measuring radiation dose (to the gonads and the skin) by each roentgenography, it was approved to be very effective to protect the gonads of the patient by the use of the lead plate 1 mm thick.
社団法人日本泌尿器科学会の論文

小児における下部尿路のレ線学的研究

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