広汎性子宮頸癌根治手術後の膀胱機能に関する研究

In the course after radical hysterectomy for carcinoma of the cervix, disturbance of the bladder function occures as a frequent and thence important complication, leading to a lasting dysuria. In our department I investigated this disturbance after the Okabayashi's operation, performing measurement before the operation, and on the 10th, 15th, 20th and 30th day after the operation. The results are as follows: 1) In 60 cases there were measured minimal volume for distension feeling, maximal capacity of the bladder, reserve pressure of micturition and the length of the urethra. There was no difference as to age, parity and clinical stage of carcinoma. It was characteristic that the minimal volume of urine feeling was increased, the minimal distension pressure elevated, the maximal capacity of the bladder decreased and the urethra shortened. In comparison to the corresponding value before the operation, they showed significant change on any day after the operation. However, the reserve pressure of micturition had no remarkable postopeative change. These changes did not appear in parallel with the degree of dysuria. 2) Intravesical pressure, before the operation the intravesical pressure had a slight increase by the filling of the contents, after the operation, a curve showing the intravesical pressure became steep in contrast to that of the preoperative day. However, the curve had no special relation to the degree of dysuria. 3) Pressure of the posterior urethra: The pressure of the internal sphincter did not vary with the bladder contents. Its absolute value varied quite often. After the the operation this pressure was markedly lowered than the preoperative value and varied in parallel with the degree of dysuria. 4) Vagostigmin, Spatym, Tropin, Buscopan, Alinamin-- these preparations were used to observe their effects on the dysuria. 5) Treatment. There were in 53 cases mechanical dilatation of the urethra. 26 cases of Alinamin administration and 17 cases of chlorpromazine administration. The mechanical dilatation was effective 71.4% of the ishuria. Ailnamin or chlorpromazine had no effect, even if adminstered early, to mitigate the period of ishuria.