| Project/Area Number |
12470325
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Urology
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| Research Institution | HOKKAIDO UNIVERSITY |
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Principal Investigator |
KOYANAGI Tomohiko Hokkaido Univ., Grad. School of Med., Professor, 大学院・医学研究科, 教授 (80001923)
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| Co-Investigator(Kenkyū-buntansha) |
MURAKUMO Masashi Hokkaido Univ., Grad. School of Med., Instructor, 大学院・医学研究科, 助手 (90261304)
KAKIZAKI Hidehiro Hokkaido Univ. Hospital, Lecture, 医学部・附属病院, 講師 (10241324)
NONOMURA Katsuya Hokkaido Univ., Grad. School of Med., Assistant Professor, 大学院・医学研究科, 助教授 (60113750)
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| Project Period (FY) |
2000 – 2001
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| Project Status |
Completed (Fiscal Year 2001)
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| Budget Amount *help |
¥14,900,000 (Direct Cost: ¥14,900,000)
Fiscal Year 2001: ¥1,500,000 (Direct Cost: ¥1,500,000)
Fiscal Year 2000: ¥13,400,000 (Direct Cost: ¥13,400,000)
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| Keywords | Children / Vesico-ureteral reflux / Urodynamics / Voiding pressure / Unstable bladder / Urethral ring (Cobb's collar) / TUI / 下部尿路症状 / 膀胱尿管逆流(VUR) / 男児 / 先天性リング状尿道狭窄(Cobb'sカラー) / 排尿圧 / 腎瘢痕 |
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| Research Abstract |
1) Urodynamic study and renal scintigraphic evaluation were done on 14 boys with primary VUR. Their ages ranged 4 months to 10 years with an average 4.2 years. 8 were bilateral and 6 unilateral. Severity of VUR were grade III or less in 8 patients and grade IV or more in 6. Voiding pressure was apparently high of 82 cm H_2O in those (7 patients) older than 3 years old (group A) while it was 57 cm H_2O in 3 patients younger. Bladder instability was not found in group B while it was noted in 57 % of group A. There was no correlation among the renal scarring, voiding pressure and/or severity of VUR. High intravesical pressure, be it during voiding or with unstable contraction, appears to be relevant in the genesis and aggravation of VUR.
2) Relevance of bulbar urethral (ring-like) stricture (i.e. Cobb's collar) to VUR was studied. In the past 5 years 74 boys (average age 5 years old) were noted to have the lesion. 54 per cent presented with febrile urinary infection and noted to have VUR. Urinary incontinence (diurnal and/or enuresis) and hematuria were also noted. Bulbar indentation was the roentgenographic feature, while all were confirmed endoscopically with infant cystourethroscope. Bladder instability was noted in 89 per cent. Transurethral incision (TUI) was effective in controlling presenting illnesses, VUR and instability over 93 per cent. In evaluating VUR in young boys the presence of congenital urethral stricture (Cobb's collar) is to be reminded.
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