排尿及び射精時に見られる肛門括約筋運動に就て
第1編 排尿と肛門括約運動
1952 年 43 巻 1 号 p. 1-9
詳細
1952 年 43 巻 1 号 p. 1-9
1) Mentioning the certain motion of the anus by urination, I have described the variation of the inner pressure of the anus by urination as a curve in 75cases, The apparatus is made up mostly of a tambour and a kymographion with a pipet attached, which rubber cap is inserted in the anus, and by this apparatus the variation of the inner pressure of the anus is described in curves.
2) In this paper the curve indicating anal pressure in case of urination and drawn on the description apparatus of my design was studied anatomically, and from the curve described, it was assumed that this curve was due mostly to the contraction and relaxation of the sphincter ani externus muscle, and further the differences between the curves described with this apparatus under certain conditions such as coughing, increasing stomach pressure or etc. was discussed.
3) The curve of the inner pressure of the anus appearing on my ano-sphinctemeter by urination could be divided in several classification, but according to the curve described by interrupting urination intentionally, by arising of desire for urination after forcing a certain amount of liquor in the bladder or by delaying the discharge of the residual urine in the urethra, I came to the conclusion that the variation of the inner pressure of the anus occuring by urination depends on the closing action of the urethra, and that this movement has the following two purposes such as the interruption of urination and discharging of contents existing in the urethra.
4) Considering the anatomical studies on perineal muscles, the portion closing the urethra, with which action the ascension of the inner pressure of the anus is accompanied, are within the sphere of the bulbocavernosus muscle and the run of its three layer of fibre and its connection with the sphincter ani muscle, it is assumed, to my belief, that when the sphincter ani muscle contracts at the sametime and equally in power with the bulbocavernosus muscle then the bulbocavernosus muscle compresses the bulbus urethrae and could press it perpendicularly toward the urethra. Further it is considered that this motion of closing the urethra is correlated with the motion closing the posterior part of the urethra.
5) In cases complaining abnormality of urination, it was understood that the variation of the inner pressure of the anus had less value in meking urological diagnosis. The characteristic variation of inner pressure of the anus in female and in the aged was also studied.
6) The reasonabillity of the plastic operation for incontinentia urinae (Flaque-Lowsley's Method) is made clear by my theory concerning the contraction of the sphincter ani muscle in closing the urethra.
