Sasagawa M, Magome A, Kikuyama A, Kobayashi S, Kawamura K, Suzuki K, Tsugawa R
Department of Urology, Keiju General Hospital.
Hinyokika Kiyo. 1991 Feb;37(2):123-8.
Clinical evaluation was made in 69 cases of neurogenic bladder experienced during the past 3 years. Thirty seven of the patients were male and 32 female, and they ranged in age from 4 to 88 years with an average of 63.2 years, The basic diseases of neurogenic bladder were brain lesions in 27 cases, spinal cord lesions in 18 cases, and peripheral nerve lesions in 13 cases. Three cases were of the mixed type and the basic disease was unknown in 8 cases. Cerebrovascular diseases were the most frequent, followed by spinal cord injuries and intrapelvic operations. Duration from the onset of urological symptoms to the first visit to our clinic was less than 1 month in half of the patients. The chief complaints at the first visit were pollakisuria in 25 cases (25.8%), incontinence in 18 cases (18.6%), urinary difficulty in 25 cases (25.8%) and urinary retention in 13 cases (13.4%). Urological conditions at the first visit were spontaneous urination in 53 cases (76.8%), indwelling catheterization in 12 cases (17.4%) and clean intermittent catheterization in 4 cases (5.8%). Urological complications seen at the first examination were urinary tract infections (UTI) in 27 cases (39.1%) and chronic renal failure in 2 cases (2.9%). The patients were classified by cystometrography into 3 patterns: 42 cases (60.9%) with underactive detrusor, 21 cases (30.4%) with overactive detrusor and 6 cases (8.7%) with normal detrusor. Detrusor sphincter dyssynergia was observed in 29 cases (42.0%), 40.7% had brain lesions, 44.4% spinal cord lesions, and 46.2% peripheral nerve lesions.(ABSTRACT TRUNCATED AT 250 WORDS)
对过去3年中收治的69例神经源性膀胱患者进行了临床评估。患者中男性37例,女性32例,年龄4至88岁,平均63.2岁。神经源性膀胱的基础疾病为脑病变27例,脊髓病变18例,周围神经病变13例。3例为混合型,8例基础疾病不明。脑血管疾病最为常见,其次是脊髓损伤和盆腔内手术。半数患者从出现泌尿系统症状到首次就诊的时间少于1个月。首次就诊时的主要症状为尿频25例(25.8%)、尿失禁18例(18.6%)、排尿困难25例(25.8%)和尿潴留13例(13.4%)。首次就诊时的泌尿系统情况为自主排尿53例(76.8%)、留置导尿12例(17.4%)和清洁间歇性导尿4例(5.8%)。首次检查时发现的泌尿系统并发症为尿路感染(UTI)27例(39.1%)和慢性肾衰竭2例(2.9%)。根据膀胱测压将患者分为3种类型:逼尿肌活动低下42例(60.9%)、逼尿肌活动亢进21例(30.4%)和逼尿肌正常6例(8.7%)。29例(42.0%)观察到逼尿肌括约肌协同失调,其中脑病变患者占40.7%,脊髓病变患者占44.4%,周围神经病变患者占46.2%。(摘要截选至250字)