上部尿路機能の研究

第3報 膀胱内圧上昇時における尿管機能

抄録

In twelve urologically normal patients and a patient with vesico-ureteral reflux the effects of the bladder filling with physiologic saline solution on the ureteral activity was examined by means of urometry and electro-ureterography.
The results are summerized as follows:
1) Urometrogram of Normal Patients
When the intravesical pressure was raised, the interval between the contractions reduced markedly, compared to the mean values obtained before saline infusion. The reduction rate was 10-75% with an average of 32.8%. Intraureteral resting pressure increased with the increased intravesicl pressure, although some delay was noted. When the resting pressure rised, the contractile pressure increased markedly, presumably to overcome the increased intravesical pressure. The duration of contractions was slightly prolonged.
2) Electro-ureterogram of Normal Patients
When the intravesical pressure was elevated, the discharge interval reduced markedly, the reduction rate being 0.7-81.0% with an average of 48.3%. The amplitude of the action potential remained unchanged. The travel rate of the potential tended to delay, the average rate of delay being 12.3%. of the value before the infusion.
3) Urometrogram and Electro-ureterogram of a Patient with Vesico-ureteral Reflux
In the urometrogram ureteral pressure fluctuations characteristic of peristalsis were detected: The contraction interval, the resting and contractile pressure were within normal range. When the bladder was filled, increase in intravesical pressure was accompanied by a simultaneous rise in the resting pressure, although the contraction interval and contractile pressure altered similarly to those of the normal patients.
In the electro-ureterogram, when the bladdrr was empty, the discharge interval, amplitude and travel rate of the action potential were altogether within normal range. When the intravesical pressure was increased, the duration of the action potential was markedly prolonged, although the discharge interval, amplitude and travel rate varied within normal range.