Suzuki T, Kurokawa K, Jimbo H, Hayashi M, Sekihara T, Takahashi H, Kato N, Yamanaka H
Department of Urology, Gunma University School of Medicine, Maebashi, Japan.
Jpn J Physiol. 1993;43(5):697-708. doi: 10.2170/jjphysiol.43.697.
We investigated venous blood drainage from the prostate into the vertebral vein system by cineangiography in five mongrel dogs and measured intraabdominal pressure and venous blood pressure in the dog or human to study the role of intraabdominal pressure in the drainage. The averages of intraabdominal pressure and caudal vena caval pressure in the dog were 32.2 +/- 3.0 and 12.8 +/- 1.3 mmHg, respectively, in the supine position, and 39.2 +/- 3.0 and 23.8 +/- 4.0 mmHg, respectively, in the head-up tilt position, when the radiopaque medium injected into the dorsal penile vein appeared in the vertebral vein system. Intraabdominal pressure in the head-up tilt position was significantly higher than that in the supine position when the venous drainage into the vertebral veins happened. In eight continuous ambulatory peritoneal dialysis patients, intraabdominal pressure showed 8.1 +/- 2.4 mmHg in the supine position, 24.6 +/- 4.3 mmHg in the sitting position, and 30.4 +/- 4.9 mmHg in the standing position at rest. During voluntary contraction of the abdominal muscles, the pressure was increased up to 50.6 +/- 21.6 mmHg in the supine position, 69.3 +/- 19.8 mmHg in the sitting position, and 73.8 +/- 19.8 mmHg in the standing position. These pressure values in the human were significantly higher than those observed at the time when the radiopaque medium appeared in the vertebral veins in both supine and head-up tilt positions in the canine. These results suggest that the increase of intraabdominal pressure causes inflow of prostatic venous blood into the vertebral veins via the inferior vena cava, common iliac vein, or internal iliac vein.
我们通过电影血管造影术在5只杂种犬中研究了前列腺静脉血向椎静脉系统的引流情况，并测量了犬或人体的腹腔内压力和静脉血压，以研究腹腔内压力在引流中的作用。犬仰卧位时腹腔内压力和下腔静脉压力的平均值分别为32.2±3.0 mmHg和12.8±1.3 mmHg，头高位倾斜时分别为39.2±3.0 mmHg和23.8±4.0 mmHg，此时注入阴茎背静脉的不透射线介质出现在椎静脉系统中。当发生向椎静脉的静脉引流时，头高位倾斜时的腹腔内压力显著高于仰卧位。在8例持续性非卧床腹膜透析患者中，仰卧位时腹腔内压力为8.1±2.4 mmHg，坐位时为24.6±4.3 mmHg，静息站立位时为30.4±4.9 mmHg。在腹部肌肉自主收缩时，仰卧位压力升高至50.6±21.6 mmHg，坐位时为69.3±19.8 mmHg，站立位时为73.8±19.8 mmHg。人体的这些压力值显著高于犬在仰卧位和头高位倾斜位不透射线介质出现在椎静脉时所观察到的值。这些结果表明，腹腔内压力升高导致前列腺静脉血经下腔静脉、髂总静脉或髂内静脉流入椎静脉。
