下部尿路の尿流動態研究 : IX エフェドリン (Adrenergic Stimulant) による腹圧性尿失禁の治療

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31 patients, 25 females and 6 males, suffering from stress incontinence were treated with the oral administration of ephedrine hydrochloride, a sympathomimetic agent. 19% of patients had neurogenic bladder dysfunction, whereas the rest suffered from the decreased urethral resistance and/or the lack of the pelvic support. The overall results; excellent 29%, effective 45% and non-effective 26%. The conventional slow-filling cystometry is one of the most desired diagnostic tools to evaluate whether the patient has the occult neurogenic bladder as well. With urethral pressure profile, stress incontinence was characterized by the decreased maximum urethral closure pressure. No statistical difference emerged in the value of the maximum urethral closure pressure and functional profile length from ephedrine treatment. An abnormal urinary flow curve was observed in 36% of cases. Cystourethrography combined with a metal chain placed in the urethra was found of value to analyze the morphologic relationship between urethra and bladder and to advise a surgical intervention in the selected cases. For a neurogenic bladder patient the supplementary therapy such as intermittent self-catheterization, imipramine and propantheline is mandatory depending upon his clinical symptoms. It should be stressed that no one can establish a solid diagmsis without performing the urodynamic studies for a patient complaining urinary incontinence.
1979-12-20