新たな尿意の獲得を目的とした回腸開放弁膀胱固定術における実験的研究

Abstract

We have previously reported about a surgical procedure, ileal flap fixation to the urinary bladder, to obtain a new voiding desire in children with congenital neurogenic bladder mainly due to spina bifida cystica, and have demonstrated satisfactory results by the procedure. The present study was conducted to physiologically elucidate the mechanism of development of the new voiding desire by the procedure by using adult female mongrel dogs. Histopathological examinations failed to reveal communication between nerves of the ileum and the urinary bladder or regeneration of nerves in the ileal flap. However, physiological examinations showed an increase in the electric activity of the mesenteric splanchnic nerve on full bladder at the portion close to the attached site of the ileal flap, and an electroneurogram of the nerve was successfully introduced. The data suggest that the extension of the ileum wall fixed to the bladder resulted in the substitute urinary sensation as the new voiding sensation which was transmitted via the vagus and splanchnic nerves of the large or small intestine.