Onishi N, Kiwamoto H, Esa A, Sugiyama T, Paku Y C, Kaneko S, Kurita T
Department of Urology, Kinki University School of Medicine.
Hinyokika Kiyo. 1989 Jul;35(7):1229-34.
Two cases of neurogenic bladder dysfunction due to tethered spinal cord syndrome in adults were experienced. They visited our hospital with the complaint of dysuria. The excretory urogram were almost normal. Urodynamic examinations revealed normoactive detrusor-overactive sphincter in case 1, and overactive detrusor-overactive sphincter in case 2. Cystometry-electromyogram demonstrated detrusor-external urethral sphincter dyssynergia in either cases. They were diagnosed as neurogenic bladder due to intraspinal tumor with spina bifida by myelography, computed tomography, and urodynamic examination. Laminectomy, subtotal extirpation of tumor and neurectomy of filum terminale were performed by orthopedists in both cases. The tumor was pathologically diagnosed as lipomas. Postoperatively they showed satisfactory recovery in micturition.
我们遇到了两例成人因脊髓拴系综合征导致神经源性膀胱功能障碍的病例。他们因排尿困难前来我院就诊。排泄性尿路造影基本正常。尿动力学检查显示,病例1为逼尿肌正常-括约肌过度活跃,病例2为逼尿肌过度活跃-括约肌过度活跃。膀胱测压-肌电图显示两例均存在逼尿肌-尿道外括约肌协同失调。通过脊髓造影、计算机断层扫描和尿动力学检查,他们被诊断为因脊柱裂伴椎管内肿瘤导致的神经源性膀胱。两名患者均由骨科医生进行了椎板切除术、肿瘤次全切除术和终丝神经切除术。肿瘤经病理诊断为脂肪瘤。术后他们的排尿功能恢复良好。