膀胱頸部硬化症修飾時の尿道内尿流動態解析

抄録

Introduction: Trans-urethral incision (TUI) is carried out as a surgical treatment for Bladder Outlet Obstruction (BOO). In the clinical practice, there are empirical patterns of the direction and the depth of incision, because mechanism of the surgical outcome to the intra-urethral flow has not been cleared. In this study, we designed models of bladder outlet and urethra and simulated the internal urine flow to study relationship between surgical incision of bladder outlet and urine flow dynamics. Method: Based on anatomical characteristic and cysto-urethroscopic image, a model of intra-urethral shape with BOO (BOO model) and the post-surgical models, incised at 6 o'clock or 5 and 7 o'clock direction of the bladder outlet (6 o'clock model and 5 - 7 o'clock model), were generated. Then the intra-urethral flow through the models was visualized and transition of fluid energy was calculated. Results: Two incise direction methods had different property in the rapid flow distribution and the occurrence of vortex, as well as the amount of energy loss thorough the urethra. Conclusion: Internal flow dynamics changes and properties by surgical incision were indicated with urine flow simulation of simplified urethral models.