| Project/Area Number |
06671561
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Urology
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| Research Institution | Hokkaido University |
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Principal Investigator |
KOBAYASHI Shinya Hokkaido Univ. School of Med., Instructor, 医学部附属病院, 助手 (80221240)
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| Co-Investigator(Kenkyū-buntansha) |
AMEDA Kananme Hokkaido Univ. School of Med., Instructor, 医学部, 助手 (60271657)
SHINNO Yuichiro Hokkaido Univ. School of Med., Assistant Professor, 医学部附属病院, 講師 (70216232)
KAKIZAKI Hidehiro Hokkaido Univ. School of Med., Instructor, 医学部附属病院, 助手 (10241324)
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| Project Period (FY) |
1994 – 1995
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| Project Status |
Completed (Fiscal Year 1995)
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| Budget Amount *help |
¥1,900,000 (Direct Cost: ¥1,900,000)
Fiscal Year 1995: ¥900,000 (Direct Cost: ¥900,000)
Fiscal Year 1994: ¥1,000,000 (Direct Cost: ¥1,000,000)
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| Keywords | Pelvic Surgery / Vesical Function / Urethral Function / Voiding Dysfunction / Urinary Incontinence / Urodynamics / Bladder Dysfunction / Urethral Dysfunction |
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| Research Abstract |
'Post-radical prostatectomy incontinence' persisted in 45% and 85% of the patients at 3 and 12 months after the operation, respectively. The restoration of continence was as sociated with an improvement in urethral closing pressre in early postoperative poriod (3 months postop. in averrage) and an increase in vesical compliance later on. Postoperative urethral denervation supersensitivity suggests some neurological injury of alpha adrenergic system in the operative procedure.
Uninary in continence recovered in 80% of the patients with Mainz type orthotopic bladder substitution at 16 months postoperatively under an averrage of 1.8 times of nocternal urination. In patients who recovered in continence lower amplitude of phasic contraction in pouchmetry, higher maxmal urethral closing pressure in urethral pressure profilometry and more prominent in crease in frequency of action potentials in external urethral sphicter electromyography in response to neobladder capacity and phasic contractio
… More
n were demonstrated compared to the patients with persistent incontinence.
Urodynamic study in the patients with radical surgery for rectal cancer demonstrated the significantly better-reserved 1ower urinary tract function in patients with pelvic nerve preserved. Rate of normalization defined from urinary flow rate and residuals was 100% vs. 31% at 6 months postoperatively in patients with preserved vs. non-preserved pelvic nerve.
Of patients with persisted voiding dysfunction for more than 12 months after radical surgery for rectal cancer, detrusor instability, vesical denervation supersensitivity were noted in 56%, 68%, 67% and 78%, respectively, indicating both vesical and urethral dysfunction contribute to voiding failure. 'Radical trasurethral resection of prostate', a modified transurethral sphincterotomy, was demonstrared to be effective treatment option that could reduce residual urine and consequently yield withdrawals of inttermitent self-catheterization without compromising urinary control in these patients. Less
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