小児の排尿機構に関する研究 : 第3報 : 小児の下部尿路閉塞性疾患の尿水力学的,電気生理学的研究

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Voiding urodynamic studies (V.U.D.) were performed in a series of 75 children with infravesical obstruction other than neurogenic bladder by simultaneously recording the abdominal pressuer, urethral pressure, vesical pressure, anal sphincter tone, electromyograms (EMG) of the anal sphincter and urinary How rate with a 6-channel polygraph. In addition, patients were tested for sacral nerve reflex wherever deemed necessary by means of urethral pressure profile (U.P.P.) and anal sphincter EMG. Through statistical analysis (by the student t-test) of data obtained for 35 voiding parameters in the V.U.D., attempts were made to clarify the voiding urodynamic characteristics in various disease states as well as to characterize the tracing patterns of individual voiding factors. The results obtained are as follows. 1) Urethral hypertonia Urethral hypertonia with spasms of the pelvic floor musculature: Both in males and females, urethral resistance was increased during micturition due to spastic pelvic floor musculature. In spite of consequent application of abdominal contraction in the facilitation of voiding, a lowered urinary flow rate and protracted urination were noted (Table 2-A). The voiding urodynamic pattern seen in this group of patients was characterized by elevation of urethral pressure and emergence of spikes in the tracing of anal sphincter tonus during urination with concomitant increments of spike discharge and increased amplitude in the anal sphincter EMG (Figs. 3-a and 3-b).
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小児の排尿機構に関する研究 : 第3報 : 小児の下部尿路閉塞性疾患の尿水力学的,電気生理学的研究

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