Development for analytic system of real-time voiding manner using the small-type trasnrectal probe

我们对实时经直肠排尿超声检查的临床效果进行了评估，以期这一新方法在评估排尿功能方面是可行的。该超声系统采用特制的小型经直肠探头，可对前列腺部和膜状部尿路的动态变化进行导航。我们首先分析了无膀胱出口梗阻患者的前列腺部和膜部尿路的开闭方式。无膀胱出口梗阻者，排尿早期膀胱颈即刻开放，前列腺及内径2~3 cm的膜状尿路持续开放，直至排尿结束。尿路的直径按比例逐渐变细。距膀胱颈1 cm处的各段尿道口的直径及开放速度均无明显差异。此外，…此外，尿流计检查中的最大尿流率与膀胱颈的开口直径有关。良性前列腺增生症患者合并膀胱出口梗阻时，在12~16s的导航时间内，难以全程导航，无法测量尿路直径。膀胱颈扩张时间较无膀胱出口梗阻者延迟，导航后8s各段内径均完全开放。前列腺癌根治术后无膀胱出口梗阻症状的患者，排尿前膀胱颈开放，有尿失禁和(或)尿路狭窄的患者膀胱颈长度明显短于无膀胱出口梗阻患者。其中，前列腺癌根治术患者的正常对照组与非前列腺癌根治术患者的尿路开放和闭合方式非常相似。较少

We assessed the clinical efficacy of real-time voiding transrectal ultrasound examination with the aim that this novel method can be feasible in evaluating urinary function. This ultrasound system using the specific small-type trasnrectal probe can be navigated the dynamic change of the prostatic urethra as well as the membrounous urethra. First, we analyzed the manner of opening and closing pattern in the prostatic and membrounous urethra in the cases without bladder outlet obstruction. In men without bladder outlet obstruction, bladder neck opened immediately in the early phase of micturition, and the prostatic as well as the membrounous urethra with the diameter measuring from 2 to 3 cm opened continuously until the ending phase of the micturition. The diameter of the urethra was tapered proportionally. There was no significant difference in each section of the diameter as well as of the opening velocity in the urethra which was located apart from 1 cm at the bladder neck. In additi … More on, maximum flow rate in the examination of the uroflowmetry was associated with the opening diameter of the bladder neck. In patients with benign prostatic hyperplasia who were suffering from bladder outlet obstruction, it was difficult to navigate all the section of the urethra, and was impossible to measure the diameter of the urethra on the navigation time between 12 and 16 seconds. The time for dilating the bladder neck was delayed compared to those without bladder outlet obstruction, and the diameters in the each section were opened completely 8 seconds after the navigation. In prostate cancer patients who were underwent radical prostatectomy and had no symptoms for bladder outlet obstruction, the bladder neck opened prior to the micturition, and the lengths for the membrounous urethra were significantly short in cases with urinary incontinence and/or urethral stricture than in those without bladder outlet obstruction. Specifically, in the normal control cases in men with radical prostatectomy, the opening and closing manner in the urethra was quite similar to that in the normal cases without the surgery of radical prostatectomy. Less