尿道撮影および内視鏡による精丘の形態的研究

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  • A MORPHOLOGICAL STUDY OF THE COLLICULUS SEMINALIS BY URETHROGRAPHY AND ENDOSCOPY
  • ニョウドウ サツエイ オヨビ ナイシキョウ ニ ヨル セイキュウ ノ ケイタイテキ ケンキュウ

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A morphological study of the colliculus seminalis has been made by means of retrograde urethrography in 654 cases, including 107 normal cases, 160 cases of benign prostatic hypertrophy, 22 cases of prostatic cancer, 47 cases of prostatism, 107 cases of seminal vesiculitis and prostatitis, 67 cases of neurogenic bladder, 45 cases of urethral stricture, 36 cases of male sterility, 17 cases of nervous urgency and 46 cases of enuresis. In addition. 80 other different cases have been subjected to a comparative study utilizing radiographic and endoscopic examination.<br>Radiographic pictures of the colliculus seminalis were classified into 7 types (Type I: club-shaped, Type II: tadpole-shaped, Type III: spindle-shaped, Type IV: belt-shaped, Type V: egg-shaped, Type VI: negative contour, Type VII: irregular deformation).<br>In normal cases, Type I was observed in 58%, Type II 24.3%, Type III, IV and V of a few percent. Type VI was observed in about 50% of benign prostatic hypertrophy and prostatic cancer. Type VII was frequently observed in prostatic cancer, in 13.6%, and followed by vesiculitis, prostatitis and neurogenic bladder.<br>The radiographic size of the colliculus seminalis was determined by the transverse diameter. By statistical analysis, above 6mm of the transverse diameter was indicated as an enlargement of the colliculus seminalis. In patients with seminal vesiculitis, prostatitis and male sterility, the transverse diameter showed a significantly larger size than normal cases with a wide distribution. This enlargement would be due to the inflammation or congestion of the colliculus seminalis. Moreover, radiographic pictures of the colliculus seminalis were unable to confirm by endoscopic observation.<br>The first 5 types based on the radiographic study were considered to be formed by the difference in prominence of the colliculus seminalis and urethral crista to the lumen of the urethra.<br>To obtain clear picture of the prostatic urethra, the author prefer to use the contrast medium with a low viscosity, and if high viscous contrast medium was used, diminishing the oblique angle of the body against the X-ray beam would be necessary.

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