レ線映画による膀胱排尿運動の研究
1960 年 51 巻 3 号 p. 229-263
詳細
1960 年 51 巻 3 号 p. 229-263
Urinational movements of 57 normal and 73 abnormal bladder were investigated by 16mm.X ray cinematographic method with film speed of 8 to 32 frames per second in which Philips image intensifier was adopted. I have obtained the more detailed and clear findings about the mechanism of micturition than that of Mizuno's reported previously.
At rest, the appearances of bladder take a symmetric and oval shape in the frontal position. After commonding to void, and there is noted a descent of the bladder base is observed becoming ovary due to the elongation of longitudinal axis and the shortning of transverse axis of the bladder. Immediately after the urinary stream occurs, the bladder contracts equally as a geometrical similar shape.
In the oblique position, the normal bladder base is flat and runs backwards and upwards at some angle with the horizontal line. The position of the internal meatus is higher than the lowest position of bladder base, but the location of it varys according to the cinefluorographic position of patient. At 45 oblique position the internal meats is observed at one-third of the backwardbladder base,
On starting to void, the internal meatus descends gradually, and takes a lowest position of the bladder base. The angle between the transverse axis of the bladder and the horizontal line becomes larger gradually, and it becomes a maximal opening at the just time of observing the urinary stream. After then the wide of the internal meatus is not changed. The difference between the high of anterior and posterior edge of the internal meatus becomes smaller after the begining of the micturition.
Voluntary interruption of the urinary stream occurs at the site of the external sphincter. After then, the anterior urethra is emptied distally by contraction of the bulbo-spongious muscle surrounding the urethra, and elevation of the bladder base is seen. At the same time a slower proximal emptying of the posterior urethra into the bladder is observed, but it is occasionally so incomplete that a small beak at bladder neck is seen in many cases.
The mechanism of micturition in the abnormal condition of the bladder such as prostate hypertrophy, functional dysuria, takes dorsalis, urethral stricture, stress incontinence, tumor of bladder, foreign body of bladder, and influences of bladder operation are described and discussed.
