Shabsigh R, Fishman I J, Krebs M
Scott Department of Urology, Baylor College of Medicine, Houston.
Br J Urol. 1988 Oct;62(4):326-30. doi: 10.1111/j.1464-410x.1988.tb04358.x.
Thirty-one combined transrectal ultrasonographic and urodynamic studies were performed in 24 patients with spinal cord lesions at different levels between C4 and T12. Ultrasonography provided accurate real-time imaging of the bladder neck, prostatic urethra and external sphincter during the bladder filling phase as well as during the voiding phase. Bladder and rectal pressures, sphincter EMG and uroflow were recorded simultaneously. Transrectal ultrasonography contributed significantly to the accuracy of diagnosing detrusor-sphincter dyssynergia. Sphincter contractions were clearly visualised with ultrasonographic video monitoring. This imaging method was especially helpful in sorting out the problems of 3 patients with poor emptying of bladder after endoscopic sphincterotomy. One had a urethral stricture and the other 2 had sphincters that opened adequately but bladders that emptied poorly because of detrusor hypocontractility. Other problems, such as benign prostatic hyperplasia and false passage, were also easily recognised. Transrectal ultrasonography not only provides accurate information but also involves no exposure to radiation and thus precludes the need for costly lead-shielded examination rooms.
对24例C4至T12不同节段脊髓损伤患者进行了31次经直肠超声检查与尿动力学联合研究。超声检查可在膀胱充盈期及排尿期对膀胱颈、前列腺尿道和外括约肌进行准确的实时成像。同时记录膀胱和直肠压力、括约肌肌电图及尿流率。经直肠超声检查对诊断逼尿肌-括约肌协同失调的准确性有显著帮助。通过超声视频监测可清晰观察到括约肌收缩情况。这种成像方法对解决3例内镜下括约肌切开术后膀胱排空不佳患者的问题特别有帮助。其中1例有尿道狭窄，另外2例括约肌开放正常，但因逼尿肌收缩无力导致膀胱排空不佳。其他问题，如良性前列腺增生和假道，也很容易识别。经直肠超声检查不仅能提供准确信息，而且无需暴露于辐射下，因此无需昂贵的铅屏蔽检查室。
