Rosi P, Del Zingaro M, Gilardi R, Biscotto S, Porena M
Clinica Urologica dell'Università degli Studi di Perugia.
Arch Ital Urol Androl. 2000 Dec;72(4):340-4.
The ultrasound study of bladder neck and urethral sphincter in men could be performed by means of transrectal ultrasound scan in longitudinal scanning or by probing the surface in transperineal scanning. The endocavitary ultrasound scan study gives the best indications in the evaluation of the bladder neck in men. The neuromuscular bladder dysfunctions' (neurologic bladder), which can be studied by ultrasound scan are dyssinergia, striped detrusor, detrusor-bladder-neck dyssinergia, detrusorial iper-reflexy bladder instability. In paraplegic subjects the exam should be performed in gynecological position or in side decubitus, and micturition is obtained by means of sovrapubic percussion and compression or with prevailing action of the abdominal press. The detrusor-striped dyssinergia is the dysfunction of the bladder where the ultrasound scan results are more meaningful and give the best elements. In these cases, already in basal conditions, could be present a bladder neck half-opened. During micturition there is an ample opening of the bladder neck and of the prostatic urethra, but scarce relaxation of the membranous urethra; sometimes a protrusion of the back lip of the bladder neck could be present too. In iper-reflexy (unstable bladders) and in detrusorial ipo-reflexy, ultrasound scans could result poorly specific and non-significative.
男性膀胱颈和尿道括约肌的超声检查可通过经直肠超声纵向扫描或经会阴扫描探测表面来进行。腔内超声扫描研究在评估男性膀胱颈方面提供了最佳指征。可通过超声扫描研究的神经肌肉性膀胱功能障碍（神经源性膀胱）包括协同失调、逼尿肌横纹肌、逼尿肌-膀胱颈协同失调、逼尿肌反射亢进性膀胱不稳定。对于截瘫患者，检查应在妇科体位或侧卧位进行，通过耻骨上叩击和压迫或主要借助腹部压力来诱导排尿。逼尿肌横纹肌协同失调是膀胱的一种功能障碍，超声扫描结果在这种情况下更有意义且能提供最佳依据。在这些病例中，在基础状态下就可能存在膀胱颈半开的情况。排尿时，膀胱颈和前列腺尿道有充分开放，但膜部尿道松弛不足；有时还可能出现膀胱颈后唇突出。在反射亢进（不稳定膀胱）和逼尿肌反射减退的情况下，超声扫描结果可能特异性较差且无显著意义。
