Development of endoscopical erectical stimulation for patients of neurogenie bladder dysfunction

神经源性膀胱功能障碍患者内窥镜勃起刺激的开发

• 批准号: 10557141
• 负责人: TSUTSUI Toshiki
• 金额: $ 8.13万
• 依托单位: NIIGATA UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (B).
• 财政年份: 1998
• 资助国家: 日本
• 起止时间: 1998 至 2000
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-10557141/
• 关键词: Neuroguic bladder; erectrical stimulation; Endoscopy; Pig; 電気刺激装置; 排尿反射; 神経因性膀胱機能障害

Experimental electrical stimulation for induction of micturition reflex was tried using rabbit urinary bladder in the first place. median incision of lower abdomen of rabbit was performed under general anesthesia. The probe of electrical stimulation was put into the bladder muscle layer, but the bladder wall was easily perforated. Thus, cystometry could not performed. Secondly, transurethral electrical stimulation using novel small diameter flexible quartz fiberscope was tried, but he insertion of this fiberscope for the urethra of rabbit was very difficult. Also, it was difficult to make sure of the field of vision because of the muddy urine of rabbit. The experimental electrical stimulation using rabbit urinary bladder was failed unfortunately. The next experiment was laparoscopic electrical stimulation of detrusor muscle layer of pig urinary bladder. Under general anesthesia, some trocars were indwelled via lower abdominal wall and the laparoscpic view was started. Two probes of erectrical stimulation were inserted from the trocars into the pig detrusor muscle of bilateral urinary bladder wall. The flexible quartz fiberscope was inserted into the urinary bladder, and no perforation of bladder mucosa by insertion of the electrical stimulations probes was found with fiberscope view. After 100ml normal saline was dripped in the bladder, cystmetry was started. The optimal condition for induction of micturition reflex was found in this experimental study. Frequency of stimulation was 20 Hz, pulse time was 2.5msec, electric current was 70mA, and duration of electrical stimulation was 15 sec. The detrusor contraction of 100 cm H2O was expressed in the cystometry under these optimal condition of electrical stimulation.

本实验首先以兔膀胱为实验动物，进行电刺激诱导排尿反射的实验。兔下腹部正中切开在全身麻醉下进行。电刺激探头置入膀胱肌层，但膀胱壁易穿孔。因此，不能进行膀胱测压。其次，我们尝试了用新型的小直径柔性石英纤维内窥镜进行经尿路电刺激，但该纤维内窥镜对兔的尿路的插入是非常困难的。此外，由于兔的尿液浑浊，很难确定视野。用兔膀胱进行的电刺激实验不幸失败了。下一个实验是在腹腔镜下电刺激猪膀胱逼尿肌层。在全身麻醉下，经下腹壁留置部分套管针，开始剖腹探查。将两个电刺激探头从套管针插入猪双侧膀胱壁逼尿肌内。将柔性石英纤维内窥镜插入膀胱内，纤维内窥镜下未发现电刺激探头插入膀胱黏膜穿孔。膀胱内滴入生理盐水100ml后，开始膀胱测压。在本实验研究中找到了诱导排尿反射的最佳条件。刺激频率20赫兹，脉冲时间2.5毫秒，电流70 mA，电刺激持续时间15秒。在这些最佳电刺激条件下，膀胱测速仪显示了100 cm H2O的逼尿肌收缩。

项目成果

武田正之: "Laparoscopic Adrenalectomy : Transperitoneal Versus Retroperitarnal Approach"Recent Advances in Endourology. (1). 47-59 (1999)

Masayuki Takeda：“腹腔镜肾上腺切除术：经腹膜与腹膜后入路”腔内泌尿学最新进展 (1)。

Masayuki Takeda, Ryusuke Watanabe, Shigenori Kurumada, Kazuhide Saito, Toshiki Tsutsui, Kota Takahashi, Hideto Go: "Endoscopic Renal Biopsy in Pediatric Patients : Comparison of Retroperitoneoscopy-Assisted and Retroperitoneoscopic Methods."Nephron. 84. 1

Masayuki Takeda、Ryusuke Watanabe、Shigenori Kurumada、Kazuhide Saito、Toshiki Tsutsui、Kota Takahashi、Hideto Go：“儿科患者的内镜肾活检：后腹膜镜辅助和后腹膜镜方法的比较。”肾单位。

Okamoto-Koizumi T, Takeda M,. Komeyama T, Hatano A., . Tamaki M, Mizusawa T., Tsutsui T., Obara K., Tomita Y., Arai K.and Takahashi K.: "Pharmacological and molecular biologiacal evidence for ETA endothelin receptor subtype mediating mechanical responses

冈本小泉 T，武田 M，。

武田正之: "神経泌尿器科学研究法"日本医学館. 172 (2000)

武田正幸：《神经泌尿学研究方法》日本医学博物馆 172（2000）。

Masayuki Takeda, A.Hatano, K.Arai, K.Obara, T.Tsutsui, K.Takahashi: "α1-and α2-Adrenoceptors in BPH."European Urology. 36(1). 31-34 (1999)

Masayuki Takeda、A.Hatano、K.Arai、K.Obara、T.Tsutsui、K.Takahashi：“BPH 中的 α1- 和 α2- 肾上腺素受体”。欧洲泌尿学 36(1)。