鎖肛病型診断にかける膀胱尿道造影手技の工夫と術後のDefecographyへの応用

抄録

Cystourethrography has assumed rmijer importance in classifjcaiion of nno-rectal anomalies. A technique for cystourethrography utilizing a small caliber catheter that is left in the posterior urethra during the entire examination is described. In male neonate or infant, 4 or 6 Fr. catheter is inserted 7 cm or 9 cm into the urethra, respectively. The catheter is taped in position and remained in place throughout the examination. This is accomplished by placing a strip of the tape on the lower abdomen, winding the tape round the shaft of the penis and the catheter without gap. The contrast is infused under pressure with syringe. Usually voiding reflex occurs soon after infusion but the contrast infusion is continued. The contrast is delivered in a steady dropled form. Repeated spot films are taken during filling of the entire urethra, combined with cologram in post-colostomy patient. A few among several spot films can accurately define the rectal fistula in relation to the bladder or urethra. This technique can be applied to post-rectoplasty defecography. After filling of the rectum with liquid barium through a small caliber catheter, the contrast is injected into the posterior urethra via the catheter. Urination may induce defecation and defecography can be performed.