担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Wiley  

Abstract

Objectives

Parkinson's disease caused by the loss of dopaminergic neurons induces not only motor dysfunction but also lower urinary tract dysfunction. Patients with Parkinson's disease have recently been reported to experience both urge urinary incontinence (overactive bladder) and stress urinary incontinence, the latter of which occurs when the pressure of the bladder exceeds that of the urethra. Vibegron is a highly selective novel β₃‐adrenoceptor agonist approved for the treatment of overactive bladder. However, how β₃‐adrenoceptor agonists affect urethral function remains unclear. In a clinical report, the urethral function of patients with Parkinson's disease was shown to be degraded. The present study aimed to investigate the effects of vibegron on lower urinary tract activity in a rat model of Parkinson's disease.

Methods

In a rat model of Parkinson's disease induced by unilateral 6‐hydroxydopamine injection into the substantia nigra pars compacta, we examined the effects of vibegron on bladder and urethral activity.

Results

Cystometric analysis revealed that, compared with vehicle injection, intravenous injection of 3 mg/kg vibegron significantly increased the inter‐contraction interval (p < .05) and reduced voiding pressure (p < .01). However, no significant effects on urethral function were observed.

Conclusions

The results of the present study provide corroborating evidence that bladder dysfunction is suppressed by the administration of vibegron in Parkinson's disease model rats, confirming that vibegron is effective for treating overactive bladder without further worsening urethral function. These findings may contribute to a better understanding of the mechanisms of β₃‐adrenoceptor agonists.

DOI： 10.1111/luts.12503

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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掲載種別：研究論文（学術雑誌）   出版者・発行元：AVES YAYINCILIK A.Ş.  

DOI： 10.5152/tud.2023.22213

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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掲載種別：研究論文（学術雑誌）   出版者・発行元：AVES YAYINCILIK A.Ş.  

DOI： 10.5152/tud.2023.22190

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   出版者・発行元：(一社)日本衛生学会  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/iju.15083

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1038/s41394-023-00559-5

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記述言語：日本語   出版者・発行元：日本老年泌尿器科学会  

世界的な長寿国である日本において、高齢者に有症率の高い尿失禁への介入は、患者の生活の質の維持と向上を測る上で重要である。理学療法では運動機能が低下した人々を対象に、身体運動機能面の回復、排泄に関わる動作の改善や、外出機会の増加などの身体活動の向上を図る。尿失禁の治療は完治が目標ではなく、生活の質の向上が目標であり、また、侵襲がなく、副作用のない理学療法は、薬物療法以前より実施することが重要であると考える。さらに、高齢者の健康は個人差が大きいことから、個々の患者に応じた慎重な対応が必要である。本稿では、尿失禁を有する高齢者に対する理学療法について概説する。(著者抄録)

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1016/j.jpurol.2022.07.012

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記述言語：日本語   出版者・発行元：(一社)日本排尿機能学会  

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1016/j.ejogrb.2022.06.022

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記述言語：日本語   出版者・発行元：日本女性骨盤底医学会  

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記述言語：日本語   出版者・発行元：日本女性骨盤底医学会  

【目的】本研究の目的は、多職種による骨盤底筋トレーニングハンズオンセミナー(本セミナー)を開催し、その効果を検討することである。【方法】対象者は、本セミナーを受講した医療従事者60名とし、骨盤底筋トレーニング指導の現状と本セミナーの満足度を調査し、受講前・受講後質問票により骨盤底筋トレーニング指導に関する自信の程度などについて比較検討した。【結果】質問票の「自分自身が骨盤底筋の正しい収縮ができる自信はありますか」、「患者さんに対して、体表から骨盤底筋の触診ができる自信はありますか」、「患者さんが骨盤底筋の正しい収縮ができているかどうかを指導することに対して、自信はありますか」の質問全てで、受講前よりも受講後で自信の程度が有意に高値を示した。【結論】本セミナーは、受講者の骨盤底筋トレーニング指導に関する自信を向上させることが示唆された。(著者抄録)

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記述言語：日本語   出版者・発行元：日本女性骨盤底医学会  

【目的】本研究の目的は、多職種による骨盤底筋トレーニングハンズオンセミナー(本セミナー)を開催し、その効果を検討することである。【方法】対象者は、本セミナーを受講した医療従事者60名とし、骨盤底筋トレーニング指導の現状と本セミナーの満足度を調査し、受講前・受講後質問票により骨盤底筋トレーニング指導に関する自信の程度などについて比較検討した。【結果】質問票の「自分自身が骨盤底筋の正しい収縮ができる自信はありますか」、「患者さんに対して、体表から骨盤底筋の触診ができる自信はありますか」、「患者さんが骨盤底筋の正しい収縮ができているかどうかを指導することに対して、自信はありますか」の質問全てで、受講前よりも受講後で自信の程度が有意に高値を示した。【結論】本セミナーは、受講者の骨盤底筋トレーニング指導に関する自信を向上させることが示唆された。(著者抄録)

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J05048&link_issn=&doc_id=20220627310006&doc_link_id=10.32310%2Fjfpfm.18.1_26&url=https%3A%2F%2Fdoi.org%2F10.32310%2Fjfpfm.18.1_26&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

記述言語：日本語   出版者・発行元：日本老年泌尿器科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Per- and Polyfluoroalkyl substances (PFAS) have endocrine-disrupting effects. The ratio of the lengths of the second and fourth digits (2D:4D) is a noninvasive retrospective index of prenatal exposure to sex hormones, and estrogen receptor 1 (ESR1) polymorphisms may contribute to 2D:4D determination. We investigated whether ESR1 polymorphisms modify the effects of prenatal PFAS exposure on 2D:4D. Participants (n = 1024) with complete data in a prospective birth cohort study (the Hokkaido Study) were included, and maternal plasma in the third trimester was used to examine PFAS concentrations. 2D:4D was determined from photocopies of palms of children using Vernier calipers. ESR1 polymorphisms (rs2234693, rs9340799, and rs2077647) were genotyped by TaqMan polymerase chain reaction. PFAS and 2D:4D association with ESR1 polymorphisms was assessed by multiple linear regression adjusted for potential confounding factors. A 10-fold increase in maternal perfluorooctanoic acid (PFOA) concentration was associated with a 1.54% [95% confidence interval (CI): 0.40, 2.68] increase in mean 2D:4D in children with an AA genotype at rs9340799 and a 2.24% (95% CI: 0.57, 3.92) increase in children with an AA genotype at rs2077647. A 10-fold increase in perfluorododecanoic acid (PFDoDA) was associated with a significant increase in 2D:4D in children with the AA genotype [rs9340799, 1.18% (95% CI: 0.02, 2.34); and rs2077647, 1.67% (95% CI: 0.05, 3.28)]. These associations were apparent among males. A significant gene-environment interaction between PFOA or PFDoDA and ESR1 polymorphism was detected. These findings suggest that ESR1 polymorphisms modify the effects of prenatal exposure to PFAS on sex differentiation.

DOI： 10.1016/j.reprotox.2022.02.002

PubMed

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

Abstract

Parkinson’s disease (PD) is a neurodegenerative condition caused by the loss of dopaminergic neurons in the substantia nigra pars compacta. As activation of dopaminergic receptors is fundamentally involved in the micturition reflex in PD, the objective of this study was to determine the effect of a single dose of rotigotine ([−]2-(N-propyl-N-2-thienylethylamino)-5-hydroxytetralin) on intercontraction interval (ICI) and voiding pressure (VP) in a rat model of PD. We used 27 female rats, PD was induced by injecting 6-hydroxydopamine (6-OHDA; 8 μg in 2 μL of 0.9% saline containing 0.3% ascorbic acid), and rotigotine was administrated at doses of 0.125, 0.25, or 0.5 mg/kg, either intravenous or subcutaneous injection. In rats with 6-OHDA-induced PD, intravenous injection of 0.25 or 0.5 mg/kg rotigotine led to a significantly lower ICI than after vehicle injection (p < 0.05). Additionally, VP was significantly lower in animals administered rotigotine compared to those injected with vehicle (p < 0.05). Compared to vehicle-injected animals, subcutaneous administration of rotigotine (0.125, 0.25, or 0.5 mg/kg) led to a significantly higher ICI at 2 h after injection (p < 0.05); however, there was no change in ICI after injection with (+)-SCH23390 hydrochloride. Dermal administration of rotigotine in a rat model of PD could suppress an overactive bladder.

DOI： 10.1038/s41598-022-08612-3

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その他リンク： https://www.nature.com/articles/s41598-022-08612-3

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/iju.15025

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jpurol.2022.11.020

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/B978-0-323-85492-4.00134-4

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1186/s12894-022-00997-7

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/iju.14930

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1186/s12905-022-01747-5

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media Deutschland GmbH  

Purpose: To clarify the incidence of and risk factors for febrile urinary tract infection in children with persistent vesicoureteral reflux (VUR) after the discontinuation of continuous antibiotic prophylaxis (CAP), retrospective chart review was performed. Patients and methods: Among children with primary VUR at 10 years of age or younger at presentation, those who had persistent VUR despite conservative management with CAP and who were subsequently followed after discontinuation of CAP were included. Kaplan–Meier curve and Cox’s proportional hazard regression model were used for evaluation of the incidence of and risk factors for febrile urinary tract infection (fUTI) after stopping CAP. Results: Among 144 children (99 boys and 45 girls), fUTI developed in 34. The 5-year fUTI-free rate after discontinuation of CAP was 69.4%. On multivariate analyses, girls (p = 0.008) and abnormalities on nuclear renal scans (p = 0.0019), especially focal defect (p = 0.0471), were significant factors for fUTI. Although the fUTI-free rate was not different between children who had no or 1 risk factor, it was significantly lower in children with 2 risk factors than in those with no or 1 risk factor. Conclusions: The present study revealed that girls and abnormal renal scan, especially focal defect, are risk factors for fUTI. Active surveillance without CAP for persistent VUR seems to be a safe option for children with no or 1 risk factor. Prophylactic surgery or careful conservative follow-up may be an option for girls with abnormal renal scan results if VUR persists under CAP.

DOI： 10.1007/s00345-020-03524-1

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PubMed

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記述言語：日本語   出版者・発行元：(一社)日本創傷・オストミー・失禁管理学会  

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier BV  

DOI： 10.1016/j.jpurol.2021.07.007

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

DOI： 10.1007/s00192-021-04761-7

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その他リンク： http://link.springer.com/article/10.1007/s00192-021-04761-7/fulltext.html

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/iju.14505

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Dove Medical Press Ltd  

Introduction: Recent guidelines do not recommend routine screening of vesicoureteral reflux after a first febrile urinary tract infection in children without abnormal findings on ultrasound or atypical/recurrent urinary tract infection. Currently, there are no clear ultra-sonographic parameters for detecting abnormalities in renal size, especially in young children. The aim of the present study was to determine an optimal cutoff value for detecting small kidney in children without apparent congenital anomalies except vesicoureteral reflux by retrospective chart review. Patients and Methods: Children aged ≤3 years who had undergone nuclear renal scans and ultrasound were enrolled. Small kidney was defined as split renal function of &lt
40%. Optimal cutoff values of various ultrasonographic parameters for detecting small kidney were calculated. Results: Of the 69 children included in the present study, small kidney was identified in 20. There was a significant difference in renal size between each kidney in patients with small kidney, whereas there was no significant difference in those without small kidney. With a ratio of estimated renal area of 74.26%, maximum area under the curve with the highest sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rate were obtained. In addition, simple measurement of renal length with a cutoff of 4.97 cm showed high specificity comparable with estimated renal area. Conclusion: Small kidney may be screened by two-dimensional measurement on ultrasono-graphic examination, even in young children. With the cutoff described, risk stratification or an individualized approach may be possible.

DOI： 10.2147/RRU.S318793

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：John Wiley and Sons Inc  

Case: We describe a rare case of pubic osteomyelitis secondary to implantation of an artificial urinary sphincter (AUS). A 49-year-old man developed total urinary incontinence due to spinal cord injury 23 years earlier. After AUS implantation, he became continent. Fourteen years later, incontinence suddenly recurred. Outcome: We planned to replace the dysfunctional AUS with a new one. We removed only the implanted control pump, leaving the urethral cuff at the bladder neck and pressure-regulating balloon to reduce surgical invasiveness, and performed AUS reimplantation. A new urethral cuff was placed around the bulbar urethra. Postoperatively, antibiotics, placement of a drainage catheter, and removal of the new AUS were required due to device infection. However, the infection persisted and magnetic resonance imaging showed inflammatory changes at the symphysis pubis, so osteotomy was performed to control infection. One year postoperatively, no gait disturbance or recurrence of pubic osteomyelitis was identified. AUS reimplantation was again performed and the patient is now socially continent. Conclusions: We have reported a rare case of pubic osteomyelitis secondary to AUS implantation. Clinicians should suspect pubic osteomyelitis if infection persists.

DOI： 10.1111/luts.12409

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: To evaluate voiding behavior characteristics in intact and sham mice, and to examine whether intact mice show changes in "normal" micturition with aging. METHODS: A total of 72 8-week-old mice were divided into two groups - intact and sham - and the latter group was subjected to a sham of partial bladder outlet obstruction surgery. Urination frequency was evaluated (through metabolic cages) at 1, 2, 3, 6 and 12 months after the surgery (or at the equivalent time points for the intact mice). To address possible mechanisms for aging and surgical effects on urinary behavior, quantitative real-time polymerase chain reaction assays were carried out. Primary data were evaluated using scatter plots and descriptive statistics. RESULTS: In sham mice, urination frequency showed strong variation at the earlier post-surgical time points (especially at 1 month), with variation decreasing with time. Quantitative real-time polymerase chain reaction showed that the serotonin 2C receptor-encoding mRNA accumulated to >28-fold higher levels at 24 months compared with 3 months in intact mice. A major limitation of the quantitative real-time polymerase chain reaction experiments was that we did not separate whole bladder into muscle and mucosa. CONCLUSIONS: Although a sham operation is typically used in partial bladder outlet obstruction experiments to provide control animals, the sham group might itself show increased variation in micturition frequency at early times after surgery, compared with intact animals.

DOI： 10.1111/iju.14460

PubMed

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

DOI： 10.1038/s41598-020-68499-w

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その他リンク： http://www.nature.com/articles/s41598-020-68499-w

記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: To investigate the effect of chronic administration of an alpha-1 blocker on micturition patterns in long-term partial bladder outlet obstruction. METHODS: Mice were divided into three groups: a normal group, in which animals were fed a standard diet; a partial bladder outlet obstruction group, in which the proximal urethra was tied and animals were fed a standard diet; and a partial bladder outlet obstruction + naftopidil group, in which the proximal urethra was tied and animals were fed a standard diet containing naftopidil. Micturition behavior was evaluated in all groups for 6 months after partial bladder outlet obstruction surgery. The parameters evaluated included voided volume, time per void, urination frequency and total urine volume. Quantitative assessment of gene expression was also carried out. RESULTS: Total urine volume, as well as total and average voided volume during night, was significantly decreased in partial bladder outlet obstruction + naftopidil mice compared with partial bladder outlet obstruction animals. The levels of transcripts encoding 5-hydroxytryptamine 2A and tissue inhibitor of metalloproteinase 2 were significantly decreased in the partial bladder outlet obstruction + naftopidil group compared with the partial bladder outlet obstruction group. CONCLUSIONS: Long-term administration of an alpha-1 blocker seems to reverse the disturbance of the micturition pattern caused by partial bladder outlet obstruction. Mechanistically, this effect might be mediated by changes in the expression of a serotonin receptor and/or in the activity of the fibrogenesis pathway.

DOI： 10.1111/iju.14377

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The purpose of this study was to clarify the reliability and validity of pelvic floor muscle (PFM) strength assessment using the MizCure perineometer in healthy women. METHODS: Twenty healthy women (age 20-45 years) participated in this study. The vaginal pressure measured using the MizCure and validated Peritron perineometers were repeated during PFM contraction in the supine and standing positions. All women were evaluated twice by examiners 1 and 2. Following the measurements in the first session (Test 1), they were repeated after an interval of between 2 and 6 weeks (Test 2). Within- and between-session intra- and inter-rater reliabilities in vaginal pressure were analyzed using intraclass correlation coefficients (ICC) (1, 1) and (2, 1), respectively. Validity was assessed by Pearson's product-moment correlation coefficient and Spearman's rank correlation analysis. RESULTS: Within-session intra-rater reliabilities for both examiners 1 and 2 for all vaginal pressures in Tests 1 and 2 were 0.90-0.96 for both perineometers. Between-session intra-rater reliability for the MizCure was 0.72-0.79 for both positions for examiner 1, and 0.63 in the supine position and 0.80 in the standing position for examiner 2. Inter-rater reliability for Test 1 was 0.91 in the supine position and 0.87 in the standing position for the MizCure. The vaginal pressures using the MizCure and Peritron were significantly associated with the supine position (r = 0.68, P < .001) and the standing position (rs = 0.82, P < .001). CONCLUSION: MizCure perineometer is a validated tool to measure PFM strength in both supine and standing positions in healthy nulliparous women.

DOI： 10.1186/s12905-020-01127-x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY  

BACKGROUND: The early detection and treatment of cryptorchidism are necessary to preserve male fertility. This study aimed to assess the effect of parents' occupational environment on the incidence of cryptorchidism in their sons. METHODS: The study enrolled 51 316 newborn males, whose mothers were recruited in the Japan Environment and Children's Study. We analyzed cryptorchidism incidence in male newborns according to 14 categories of occupation of their parents. We also analyzed the effect of the mother's occupational environment during gestation, including working and night-shift work, on cryptorchidism incidence. Information on occupations was obtained from self-administered questionnaires. Cryptorchidism was identified through a survey at birth or 1 month after birth using medical records. RESULTS: Cryptorchidism was identified in 305 male infants (0.59%) at birth or 1 month after birth. Weight, height, head circumference, and chest circumference at birth were significantly lower in male infants with cryptorchidism than in those without the condition. Gestational age was also shorter in mothers whose infants developed cryptorchidism. Moreover, maternal age at delivery and smoking during gestation also had an effect on cryptorchidism incidence. However, multivariate analysis of the 14 categories of occupation of parents during gestation showed no significant effect on cryptorchidism incidence in their male infants. CONCLUSIONS: This study revealed that the work environment of parents did not significantly affect the incidence of cryptorchidism in their sons. However, this study might have underestimated mild and transient cases of cryptorchidism. Further studies are necessary to investigate the risk factors of cryptorchidism in relation to parents' occupation.

DOI： 10.1111/ped.14316

Web of Science

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier Inc.  

Sacrococcygeal teratoma (SCT) is the most common fetal and neonatal tumor. While SCT is often associated with urological problems, the association between SCT and a urogenital sinus (UGS) anomaly is rare. A concurrent UGS anomaly may be an acquired condition due to resection of SCT because it is rarely found at birth. In our case in whom fetal imaging study showed an abdominal cystic lesion, SCT with a UGS anomaly was suspected at birth and confirmed by endoscopy before resection of SCT during the neonatal period. These findings revealed that UGS anomaly may develop congenitally.

DOI： 10.1016/j.epsc.2020.101587

Scopus

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Although Parkinson's disease (PD) is characterized by the loss of dopaminergic neurons in the substantia nigra and subsequent motor symptoms, various non-motor symptoms often precede these other symptoms. While motor symptoms are certainly burdensome, a wide range of non-motor symptoms have emerged as the key determinant of the quality of life in PD patients. The prevalence of lower urinary tract symptoms differs according to the study, with ranges between 27% and 63.9%. These can be influenced by the stage of disease, the presence of lower urinary tract-related comorbidities, and parallels with other manifestations of autonomic dysfunction. Animal models can provide a platform for investigating the mechanisms of PD-related dysfunction and for the assessment of novel treatment strategies. Animal research efforts have been primarily focused on PD motor signs and symptoms. However, the etiology of lower urinary tract dysfunction in PD has yet to be definitively clarified. Several animal PD models are available, each of which has a different effect on the autonomic nervous system. In this article, we review the various lower urinary tract dysfunction animal PD models. We additionally discuss techniques for determining the appropriate model for evaluating the development of lower urinary tract dysfunction treatments.

DOI： 10.3390/ijms21186520

PubMed

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記述言語：日本語   出版者・発行元：日本理学療法士学会  

<p>【目的】本研究の目的は，腹圧上昇肢位が骨盤底筋と体幹・下肢筋群の共同収縮に及ぼす影響を検討することである。【方法】若年未経産婦15 名（平均年齢25.5 ± 2.5 歳）を対象とし，肢位要因（背臥位，立位，中腰位，中腰位で重量物を挙上した肢位（重錘挙上位））と課題要因（安静時，骨盤底筋収縮時）の2 要因での腟圧値と筋活動量（腹直筋，外・内腹斜筋，多裂筋，大殿筋，股内転筋）の比較と，各肢位間で骨盤底筋収縮時における被験筋筋活動増加率について比較検討した。【結果】課題要因では骨盤底筋収縮時に腟圧値と各筋活動量が有意に高値を示し，肢位要因では中腰位と重錘挙上位で腟圧値と各筋活動量が有意に高値を示した。筋活動増加率は内腹斜筋が背臥位，立位，中腰位で他筋よりも有意に高値を示した。【結論】内腹斜筋は他筋と比較して，中腰位，背臥位，立位において骨盤底筋との共同収縮筋としての活動が増加することが示唆された。</p>

DOI： 10.15063/rigaku.11682

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: To identify the types of serotonin (5-hydroxytryptamine) receptors of the prefrontal cortex related to the micturition reflex. METHODS: Female Sprague-Dawley rats and a microinjection method were used for this study. Stainless steel guide cannulas were implanted bilaterally into the prefrontal cortex, and a polyethylene catheter was inserted into the bladder. Cystometric parameters (intercontraction interval and maximum voiding pressure) were measured before and after injection of any one of six specific antagonists of 5-hydroxytriptamine receptors (5-hydroxytryptamine 1A, 5-hydroxytryptamine 2A, 5-hydroxytryptamine 2C, 5-hydroxytryptamine 3, 5-hydroxytryptamine 4 and 5-hydroxytryptamine 7) into the prefrontal cortex. The prefrontal cortex was divided into two regions, namely the prelimbic cortex and the infralimbic cortex. The experiments were carried out in conscious and free-moving rats. RESULTS: The intercontraction interval value increased significantly after injection of the 5-hydroxytriptamine 2A receptor antagonist, MDL11939, into the prelimbic cortex of the rat prefrontal cortex (7.68 ± 1.28 vs 9.02 ± 1.41 min, P < 0.05), whereas the intercontraction interval value decreased significantly after injection of the 5-hydroxytriptamine 7 antagonist SB269970 into the prelimbic cortex (9.42 ± 0.39 vs 8.14 ± 0.71 min, P < 0.05). The intercontraction interval was unaffected by injection of either of these two antagonists into the infralimbic cortex. The other four antagonists (5-hydroxytryptamine 1A, 5-hydroxytryptamine 2C, 5-hydroxytryptamine 3 and 5-hydroxytryptamine 4) had no effect on the intercontraction interval after injection into the prelimbic cortex and the infralimbic cortex. The maximum voiding pressure was unaffected by injection of any one of the six 5-hydroxytriptamine antagonists into the prelimbic cortex and infralimbic cortex. CONCLUSIONS: In the rat prefrontal cortex5-hydroxytryptamine 2A receptors excite the micturition reflex, whereas 5-hydroxytryptamine 7 receptors inhibit this reflex.

DOI： 10.1111/iju.14267

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: To the best of our knowledge, no study has examined the reliability of assessment methods for male pelvic floor muscle (PFM) function. Therefore, this study aimed to clarify the reliability of manometry with an anal sensor (Peritron cat 9300A) to assess PFM function in healthy men. METHODS: Healthy male subjects (n = 21) without urinary leakage underwent testing to assess PFM function, and intra- and interrater reliability tests among examiners were performed. The PFM function included maximal anorectal squeeze pressure, endurance, mean anorectal squeeze pressure, gradient, and area under the curve during PFM voluntary contraction. RESULTS: Participants had a median age of 38 years (range 26-51), and a mean BMI of 23.2 ± 2.0 kg/m2 . Satisfactory intra- and interrater reliability scores were found for resting pressure, anorectal squeeze pressure, and endurance. The intra-rater reliability of resting pressure, anorectal squeeze pressure, and endurance were 0.71, 0.89, and 0.75 for examiner 1 and 0.72, 0.89, and 0.87 for examiner 2. The interrater reliability for resting pressure, anorectal squeeze pressure, and endurance were 0.58, 0.93, and 0.61, respectively. CONCLUSIONS: This is the first prospective study showing the favorable intra- and interrater reliability of manometry for PFM function in healthy men. Our findings demonstrated that manometry can provide both reliable and reproducible data regarding PFM function in continent men, suggesting Peritron cat 9300A can be used to evaluate the PFM function in men.

DOI： 10.1002/nau.24374

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: Pelvic organ prolapse (POP) is relatively common in the elderly population. Laparoscopic sacrocolpopexy (LSC) has been reported by several studies to be a less invasive treatment option as compared to open sacrocolpopexy. However, almost all prior reports focused on the complications or surgical obstacles. The present study was designed to examine POP patients of all ages and assess lower urinary tract function before and after LSC. METHODS: This retrospective study examined the results of LSC performed in POP patients. Urodynamic studies were performed pre- and postoperatively in 50 patients, with the subjects divided into two groups containing those less than and those older than 65 years of age. We performed a pressure flow study. We examined bladder functions by evaluating bladder capacity, detrusor pressure at maximum flow (PdetQmax), maximum flow rate (Qmax), normal desire to void, strong desire to void, voided volume, and postvoid residual volume (PVR). Statistical analysis was performed using Wilcoxon signed rank test. Values of P < .05 were considered significant. RESULTS: With regard to the pressure-flow study parameters, there was a significant increase in the normal desire to void and bladder capacity only in the ≥65 age group. After the operation, there was a significant increase in the mean postoperative Qmax and voided volume, while there was a significant decrease in the PdetQmax and PVR as compared to the preoperative values only in the ≥65 age group. CONCLUSIONS: Results show that in elderly patients with POP, LSC might be a valid option with regard to potentially regaining urinary tract function.

DOI： 10.1111/luts.12313

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器科学会  

症例は17歳男性.生後2ヵ月時に左多精巣症と診断されたが,陰嚢内であり無症状であったため経過観察となっていた.17歳時に左急性陰嚢症を発症し,超音波検査にて左精巣捻転と診断され発症4時間後に,緊急手術が施行された.術中所見では,左頭側精巣が反時計回りに720度捻転していた.捻転解除により色調の改善を認めたため,頭側精巣生検を行い,両側精巣固定を行った.病理所見では,悪性所見を認めず,精子形成能は保たれていた.術後1年半経過するが,血流は良好で,精巣の萎縮はなく経過している.多精巣症は稀な疾患であり,幼少期に無症状で発見された陰嚢内に存在する多精巣症に対する治療方針は明らかではない.過去の報告では,停留精巣の有無により悪性腫瘍の発生頻度が異なることが報告されていることから,停留精巣の有無により治療方針を検討する必要がある.保存的な経過観察を推奨する意見もあるが,初期治療として経過観察を行ったとしても腫瘍発生や捻転のリスクを考慮したうえでの待機的な外科的処置も選択肢となりうる.(著者抄録)

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器科学会  

症例は17歳男性.生後2ヵ月時に左多精巣症と診断されたが,陰嚢内であり無症状であったため経過観察となっていた.17歳時に左急性陰嚢症を発症し,超音波検査にて左精巣捻転と診断され発症4時間後に,緊急手術が施行された.術中所見では,左頭側精巣が反時計回りに720度捻転していた.捻転解除により色調の改善を認めたため,頭側精巣生検を行い,両側精巣固定を行った.病理所見では,悪性所見を認めず,精子形成能は保たれていた.術後1年半経過するが,血流は良好で,精巣の萎縮はなく経過している.多精巣症は稀な疾患であり,幼少期に無症状で発見された陰嚢内に存在する多精巣症に対する治療方針は明らかではない.過去の報告では,停留精巣の有無により悪性腫瘍の発生頻度が異なることが報告されていることから,停留精巣の有無により治療方針を検討する必要がある.保存的な経過観察を推奨する意見もあるが,初期治療として経過観察を行ったとしても腫瘍発生や捻転のリスクを考慮したうえでの待機的な外科的処置も選択肢となりうる.(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J01175&link_issn=&doc_id=20200512400004&doc_link_id=130008027799&url=https%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F130008027799&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

The present article is an abridged English translation of the Japanese clinical guidelines for the diagnosis and treatment of lower urinary tract dysfunction in patients with spinal cord injury updated as of July 2019. The patients are adult spinal cord injured patients with lower urinary tract dysfunction; special consideration of pediatric and elderly populations is presented separately. The target audience is healthcare providers who are engaged in the medical care of patients with spinal cord injury. The mandatory assessment includes medical history, physical examination, frequency-volume chart, urinalysis, blood chemistry, transabdominal ultrasonography, measurement of post-void residual urine, uroflowmetry and video-urodynamic study. Optional assessments include questionnaires on the quality of life, renal scintigraphy and cystourethroscopy. The presence or absence of risk factors for renal damage and symptomatic urinary tract infection affects urinary management, as well as pharmacological treatments. Further treatment is recommended if the maximum conservative treatment fails to improve or prevent renal damage and symptomatic urinary tract infection. In addition, management of urinary incontinence should be considered individually in patients with risk factors for urinary incontinence and decreased quality of life.

DOI： 10.1111/iju.14186

PubMed

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記述言語：英語  

Phthalates and bisphenol A (BPA) are estrogenic endocrine disruptors. Polymorphisms in the gene encoding estrogen receptor 1 (ESR1) may contribute to the ratio of the lengths of the second and fourth digits (2D:4D), which is considered an index of prenatal exposure to sex hormones. Thus, we investigated whether ESR1 polymorphisms modify the effects of prenatal exposure to phthalates and BPA on 2D:4D in a birth cohort. Maternal serum in the first trimester was used to determine prenatal exposure to these compounds. Six hundred twenty-three children (7 years of age) provided mean 2D:4D from photocopies and were genotyped for single nucleotide polymorphisms in ESR1, particularly PvuII (T > C, dbSNP: rs2234693), XbaI (A > G, dbSNP: rs9340799), and rs2077647 (A > G). The associations among compound exposure, mean 2D:4D, and ESR1 polymorphisms were assessed by multiple linear regression adjusted for potential cofounding factors. Boys with the AG/GG genotype at rs2077647 in the group exposed to high levels of mono(2-ethylhexyl) phthalate (MEHP) or Σ Di(2-ethylhexyl) phthalate (DEHP) showed feminized 2D:4D compared with boys with the AA genotype at rs2077647 who had low exposure to MEHP or ΣDEHP (MEHP: increase in mean 2D:4D of 1.51%, 95% confidence interval [CI]: 0.40-2.63; ΣDEHP: increase in mean 2D:4D of 1.37%, 95% CI: 0.25-2.49). No significant differences were found among girls. There were no associations between mean 2D:4D and metabolites other than MEHP or BPA. These data suggest that ESR1 polymorphisms modify the effects of prenatal exposure to DEHP on mean 2D:4D among boys.

DOI： 10.1016/j.steroids.2020.108637

PubMed

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記述言語：日本語   出版者・発行元：(公社)日本薬理学会  

膀胱と尿道からなる下部尿路は蓄尿と尿排出の二つの相反する機能を司り,その機能は,末梢神経だけでなく中枢神経路を介して複雑にコントロールされている.まず,蓄尿時の調節は,主に脊髄レベルの反射によって制御され,交感神経(下腹神経),体性神経(陰部神経)の興奮によって膀胱の弛緩と尿道の収縮が引き起こされる.そして,尿排出時には,脊髄から脳幹の橋排尿中枢を経由する反射経路が活性化され,副交感神経(骨盤神経)の興奮によって排尿が起こる.そして,これらの末梢神経の働きは,脊髄より上位の中枢神経によって複雑に制御され,随意のコントロールが可能となる.そして中枢での神経伝達物質としてドパミン,セロトニン,ノルエピネフリン,GABA,グルタミン酸などが排尿のコントロールに関与しており,末梢だけでなく,中枢神経路の変性疾患や外傷による障害および薬物投与が,頻尿,尿失禁,尿排出力低下などの下部尿路機能障害を引き起こす.(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J01200&link_issn=&doc_id=20200110500001&doc_link_id=130007778970&url=https%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F130007778970&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

The functions of the lower urinary tract, to storage and periodically release urine, are dependent on the activity of smooth and striated muscles in the bladder, urethra and external urethral sphincter. This activity is in turn controlled by neural circuits not only in the periphery, but also in the central nervous system (CNS). During urine storage, the outlet is closed and the bladder smooth muscle is quiescent by the neural control mechanism mainly organized in the spinal cord. When bladder volume reaches the micturition threshold, activation of a micturition center in the dorsolateral pons (the pontine micturition center) induces micturition through activation of sacral parasympathetic (pelvic) nerves. The brain rostral to the pons (diencephalon and cerebral cortex) is also involved in excitatory and inhibitory regulation of the micturition reflex. Various transmitters including dopamine, serotonin, norepenephrine, GABA, excitatory and inhibitory amino acids, opioids and acetylcholine are implicated in the modulation of the micturition reflex in the CNS. Therefore, injury or neurodegenerative diseases of the CNS as well as drugs can produce bladder and urethral dysfunctions such as urinary frequency, urgency and incontinence or inefficient bladder emptying.

DOI： 10.1254/fpj.19107

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/iju.14262

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

Left polyorchidism was found in a 2-month-old boy with a left scrotal mass. As he was asymptomatic and all testes were in the scrotum, he was conservatively followed up. At 17 years of age, he presented with left acute scrotum due to testicular torsion of the left supernumerary testis. Counterclockwise 720-degree rotation of the left supernumerary testis was noted during emergency surgery, and orchidopexy of the 3 testes (2 left testes and 1 right testis) was performed. Biopsy of the left supernumerary testis demonstrated spermatogenesis and no malignancy. One and a half years after surgery, all testes were viable without atrophy.Polyorchidism is a rare condition and there is no consensus on the management of asymptomatic cases detected early in life. The position of the supernumerary testis (intrascrotal or extrascrotal) is important when deciding the management strategy because of the risk of malignancy. If conservative management is selected initially, elective surgery, such as prophylactic orchiectomy or orchidopexy, may be needed because of the risk of malignancy and torsion.

DOI： 10.5980/jpnjurol.111.53

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer  

Purpose: The factors affecting spermatogenesis in adulthood in patients with hypospadias (HS) are not clearly understood. In the present study, risk factors affecting post-pubertal high serum follicle-stimulating hormone (FSH) were evaluated in patients with HS. Materials and methods: Among those with a history of HS surgery, patients in whom endocrinological evaluation regarding pituitary–gonadal axis was performed at 15 years of age or older between March 2004 and April 2018 were enrolled in the present study. High serum FSH was defined as greater than 10 mIU/ml. The severity of HS was divided into mild and severe. Factors affecting the post-pubertal high serum FSH were estimated. Results: Seventy-nine patients were included in the present study. The severity of HS was mild in 35 and severe in 44. History of undescended testis (UDT) was confirmed in 12. High serum FSH was detected in nine. On logistic regression model analysis, a history of UDT was the only significant factor for high serum FSH. The incidence of high serum FSH in patients with UDT was significantly higher than that in those without UDT (58.3% vs 7.5%, p &lt
0.01). When stratified by severity of HS and the presence of UDT, high serum FSH was detected in 70% in patients with severe HS and UDT, whereas less than 10% in other groups. Conclusions: A history of UDT was a significant factor for post-pubertal high serum FSH in patients with HS. Accordingly, the presence of UDT may be a marker for impaired spermatogenesis in patients with HS, especially in severe cases.

DOI： 10.1007/s00345-019-02687-w

Scopus

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier Inc  

He was born with markedly dilated left megaureter. Since it disturbed his oral intake after birth, left temporary cutaneous ureterostomy was created at 3 days of age. Since his left kidney was dysplastic, laparoscopic left nephroureterectomy was performed using the stoma site of cutaneous ureterostomy as a multi-channel port site at 15 months of age. He had no complications after surgery, and the postoperative wound appearance was good. This is the first report of the stoma site being used as a multi-channel port site in the urology field. This surgical approach provides good cosmetic outcomes.

DOI： 10.1016/j.eucr.2019.100990

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Pediatric Urology Case Reports  

DOI： 10.14534/j-pucr.2019554534

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記述言語：日本語   出版者・発行元：(一社)日本排尿機能学会  

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記述言語：日本語   出版者・発行元：(一社)日本理学療法学会連合  

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記述言語：英語  

AIM: The hiatal anterior-posterior distance (APD), as measured by two-dimensional (2D) transperineal ultrasonography, is an indicator of pelvic floor muscle (PFM) contractility. The function of the pelvic floor is independently related to pelvic organ prolapse (POP) severity. However, little evidence concerning the APD for patients with POP before and after PFM training (PFMT) has been published. Therefore, we analyzed 2D transperineal ultrasonography in women with POP. METHODS: Twenty-eight women with POP completed a physiotherapist-led PFMT regimen that consisted of 4 months of one-on-one PFMT and lifestyle advice. The APD was measured using 2D transperineal ultrasonography immediately before and after the PFMT period and used to calculate ΔAPD (APD at rest-APD during contraction). Vaginal squeeze pressure during maximum voluntary contractions was also assessed using a manometer. We then analyzed the reliability and the correlation between ΔAPD as measured using 2D transperineal ultrasonography and vaginal squeeze pressure before and after PFMT. RESULTS: The APD at rest and during PFM contractions demonstrated intraclass correlation coefficients (ICCs) of 0.89 and 0.88, respectively. The ICC of maximal vaginal squeeze pressure was 0.97 during PFM contractions. Both ΔAPD (P < 0.01) and PFM strength (P < 0.05) increased significantly after PFMT. PFM strength and ΔAPD were correlated before (R = 0.53) and after (R = 0.68) PFMT (P < 0.01). CONCLUSIONS: We demonstrated that dynamic 2D transperineal ultrasonography could be used for studying functional changes in patients with POP. The ΔAPD of the levator hiatus has potential as an anatomical surrogate marker for evaluating PFM function in hospitals.

DOI： 10.1002/nau.23987

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記述言語：英語  

AIMS: Urinary incontinence is prevalent among patients with Parkinson's disease (PD). In the present study, we investigated urethral functions in a rat model of PD induced by 6-hydroxydopamine injection at their substantia nigra pars compacta as well as the roles of selective agonists/antagonist of dopamine D1- and D2-like receptors in active urethral closure mechanisms. METHODS: We measured changes in the urethral pressure amplitude during electrical stimulation, urethral baseline pressure, and leak point pressure after intravenous administration of selective agonists or antagonists of the dopamine D1- and D2-like receptors in a rat model of PD. RESULTS: The mean leak point pressure and the mean active urethral response values were significantly smaller for the untreated PD rat group compared with the control group. In PD model, the active urethral response increased significantly after treatment with the dopamine D1-like receptor agonist, whereas that induced by the dopamine D2-like receptor agonist decreased significantly. The response to the D2-like receptor agonist was suppressed in the PD rat by the dopamine D2-like receptor antagonist. CONCLUSION: Our results suggest that the active urethral closure mechanisms are significantly impaired when dopamine is depleted. In the PD rat, dopamine D1-like receptor activity on the central nervous system appear to partially compensate for urethral functions negatively impacted by the lack of dopamine, whereas dopamine D2-like receptor activity might exacerbate urinary leakage owing to the negative effect of this activated receptor on urethral pressure under increased intra-abdominal pressure.

DOI： 10.1002/nau.23989

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記述言語：日本語   出版者・発行元：医学図書出版(株)  

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器科学会総会事務局  

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記述言語：英語  

BACKGROUND: We investigated the association between the hormone environment during the prenatal period using cord blood, and gender-role play behavior in school-aged children. METHODS: A total of 879 school-aged children (433 boys and 446 girls) in a prospective birth cohort study in Hokkaido were enrolled to analyze the relationship between cord blood level of the sex hormones estradiol (E), testosterone (T), progesterone (P), and dehydroepiandrosterone (DHEA), and the Pre-School Activities Inventory (PSAI) score. The PSAI evaluated sex-typical characteristics, the type of preferred toys and play activities. The PSAI consists of 12 masculine and 12 feminine items, and the composite scores were calculated by subtracting the feminine score from the masculine score. Higher scores indicated male-typical behavior. RESULTS: Composite and masculine PSAI scores were significantly higher in boys. Meanwhile, the feminine score was significantly lower in boys. Although T and P were significantly higher in boys, E/T was significantly higher in girls. In a multivariate regression model, including covariates of social factors, there was no correlation between any of the hormones and PSAI score in boys. In girls, only P and E/T were positively correlated with the feminine score. CONCLUSIONS: Prenatal sex hormone exposure may influence the dimorphic brain development and behavior in school-aged girls. Furthermore, the cord blood hormone levels may not fully reflect the hormone environment during the prenatal period.

DOI： 10.1111/ped.13756

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DOI： 10.1016/j.steroids.2018.11.011

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1097/OGX.0000000000000728

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/iju.13862

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/iju.13892

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/iju.13833

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DOI： 10.1002/nau.23586

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

To clarify the role of serotonin (5-HT) in the prevention of stress urinary incontinence (SUI) during sneezing, we investigated the effect of intraperitoneal application of p-chlorophenylalanine (PCPA; a serotonin synthesis inhibitor) and intravenous application of CP-809101 (a 5-HT2C agonist) or LP44 (a 5-HT7 agonist) using female rats, in which the neurally evoked continence reflex during sneezing was examined. Amplitudes of urethral pressure response during sneezing (A-URS), urethral baseline pressure (UBP) at the middle urethra, and sneeze-induced leak point pressure (S-LPP) were measured in normal female adult rats with or without drug administration. PCPA decreased A-URS by 35.1 cmH2O and UBP by 13.3 cmH2O compared with normal rats. In PCPA-administrated rats, CP-809101 increased A-URS by 24.1 cmH2O and UBP by 15.1 cmH2O, and LP44 also increased A-URS by 20.6 cmH2O and UBP by 11.4 cmH2O compared with rats treated with PCPA alone. SUI was observed with S-LPP of 40.1 cmH2O in PCPA-administrated rats, in which CP-809101 and LP44 increased S-LPP by 28.0 and 15.2 cmH2O, respectively, compared with rats treated with PCPA alone. The effects of CP-809101 and LP44 were antagonized by SB-242084 (a selective 5-HT2C antagonist) and SB-269970 (a selective 5-HT7 antagonist), respectively. These results indicate that activation of 5-HT receptors enhances the active urethral closure reflex during sneezing, at least in part via 5-HT2C and 5-HT7 receptors.

DOI： 10.1152/ajprenal.00614.2017

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DOI： 10.1016/j.ejogrb.2018.04.015

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DOI： 10.1186/s12887-018-1151-6

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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DOI： 10.1002/ajhb.23127

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記述言語：英語   出版者・発行元：Blackwell Publishing  

The functions of the lower urinary tract have been investigated for more than a century. Lower urinary tract symptoms, such as incomplete bladder emptying, weak urine stream, daytime urinary frequency, urgency, urge incontinence and nocturia after partial bladder outlet obstruction, is a frequent cause of benign prostatic hyperplasia in aging men. However, the pathophysiological mechanisms have not been fully elucidated. The use of animal models is absolutely imperative for understanding the pathophysiological processes involved in bladder dysfunction. Surgical induction has been used to study lower urinary tract functions of numerous animal species, such as pig, dog, rabbit, guinea pig, rat and mouse, of both sexes. Several morphological and functional modifications under partial bladder outlet obstruction have not only been observed in the bladder, but also in the central nervous system. Understanding the changes of the lower urinary tract functions induced by partial bladder outlet obstruction would also contribute to appropriate drug development for treating these pathophysiological conditions. In the present review, we discuss techniques for creating partial bladder outlet obstruction, the characteristics of several species, as well as issues of each model, and their translational value.

DOI： 10.1111/iju.13471

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier Inc.  

Purpose We performed a multicenter, prospective, observational study to assess outcomes, including changes in continence status and quality of life, after artificial urinary sphincter implantation. Materials and Methods Prospectively enrolled in this study were 135 patients who underwent primary AMS 800™ implantation between 2011 and 2014 at 1 of 5 institutions. Perioperative complications were categorized according to the Clavien-Dindo classification. We estimated the revision-free rate, that is the incidence of patients who did not undergo artificial urinary sphincter revision surgery. Cox regression analysis was performed to identify patient risk factors for revision surgery. The number of pads needed per day, ICIQ-SF (International Consultation on Incontinence Questionnaire-Short Form) and KHQ (King's Health Questionnaire) were used to estimate continence status and quality of life preoperatively, and 1, 3 and 12 months postoperatively. Results The artificial urinary sphincter was implanted without major complications. The revision-free rate 1, 2 and 3 years after implantation was 94%, 88% and 81%, respectively. Diabetes mellitus and poor preoperative American Society of Anesthesiologists® physical status were significant risk factors for revision surgery. Continence status and quality of life were markedly improved after surgery. However, ICIQ-SF and some KHQ items showed slight but significant deterioration at 12 months compared with scores 1 month after surgery. Conclusions Artificial urinary sphincter implantation is a safe and durable procedure that substantially improves patient continence status and quality of life soon after surgery. Our results indicate that patients start to experience slight but noticeable deterioration in continence status and quality of life relatively early (within 1 year) after surgery. This finding might be helpful with appropriately counseling patients who undergo artificial urinary sphincter implantation.

DOI： 10.1016/j.juro.2017.08.077

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/iju.13513

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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DOI： 10.1007/s11255-017-1770-0

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DOI： 10.1002/jum.14509

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Multiple vaginal parities have been reported to be an important risk factor for stress urinary incontinence (SUI). Simulated birth trauma with single vaginal distention (VD) has been used to induce the SUI condition in animals; however, the effect of multiple simulated birth traumas on the urethral continence function has not been well characterized. Therefore, we examined the effects of multiple VDs on urethral functions in vivo and the changes in gene expressions of several molecules in the urethra using female SD rats, which were divided into three groups; sham, VD-1 (single VD), and VD-3 groups (3 times of VDs every 2 wk). Two weeks after the final VD, leak point pressure (LPP) and urethral responses during sneezing were evaluated. Also, changes in mRNA levels of urethral molecules were quantified with RT-PCR. The VD-1 group did not show any change in LPP with only a tendency of decrease in amplitudes of the urethral responses during sneezing (A-URS); however, the VD-3 group showed a significant decrease in LPP and urethral responses such as baseline urethral pressure and A-URS accompanied with SUI episodes during sneezing. Nicotinic receptor subtypes and transforming growth factor (TGF)-β1 were significantly increased in both VD-1 and VD-3 groups while TNF receptor (TNFR)-1, IL-6, collagens, and matrix metalloproteinases-9 were significantly increased only in the VD-3 group. These data indicate that rats with multiple simulated birth traumas exhibit profound impairment of the urethral continence function and that these functional changes are associated with those in cytokines, extracellular matrix molecules, and nicotinic receptor subtypes in the urethra.

DOI： 10.1152/ajprenal.00230.2017

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

OBJECTIVE To clarify the prevalence and chronological changes of testicular microlithiasis in isolated congenital undescended testes, retrospective chart review was performed.
MATERIALS AND METHODS Among children with palpable isolated undescended testes who underwent orchiopexy at less than 3 years of age between January 2009 and May 2016, those who had preoperative testicular ultrasonography were enrolled. Testicular microlithiasis was classified as limited or classic.
RESULTS Sixty-five patients (54 unilateral undescended testes and 11 bilateral undescended testes) were enrolled. Preoperative evaluation demonstrated limited testicular microlithiasis in only 2 undescended testes in 2 patients (1 with unilateral undescended testes and 1 with bilateral undescended testes). Of these patients, 1 with unilateral undescended testes had limited testicular microlithiasis and the other with bilateral undescended testes had classic testicular microlithiasis after surgery. Among 53 unilateral undescended testes without microlithiasis preoperatively, limited and classic testicular microlithiasis was found in 1 and 6 testes, respectively, during followup. Testicular microlithiasis was identified in 2 on the contralateral descended testis of unilateral undescended testes postoperatively. Among 10 patients with bilateral undescended testes without microlithiasis preoperatively, limited testicular microlithiasis was detected in 4 during follow-up. Testicular microlithiasis was not diminished or resolved during follow-up. The overall prevalence of testicular microlithiasis in undescended testes (21.1%) was significantly higher than that in the contralateral descended testis in patients with unilateral undescended testes (3.7%) (P &lt;.01).
CONCLUSION Most testicular microlithiasis was identified postoperatively and never improved. The prevalence of testicular microlithiasis in isolated congenital undescended testes increased with time even if operated on early in life. 2017 Elsevier Inc.

DOI： 10.1016/j.urology.2017.07.035

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器内視鏡学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY  

Objective
To clarify the impact of endoscopic incision (EI) for ureterocele as an initial procedure, by performing a retrospective chart review, focusing on the prevalence of and risk factors for symptomatic urinary tract infection (UTI) after EI.
Materials and Methods
In the present study we included children with ureterocele, managed between September 1994 and April 2016, who were observed conservatively without additional surgical management after EI. Ureterocele was categorized as intravesical or ectopic. Symptomatic UTI was defined as either recurrent non-febrile or febrile UTI. The prevalence of and risk factors for symptomatic UTI were analysed using Cox proportional hazard models or Kaplan-Meier curves, and the log-rank test.
Results
A total of 36 children met the inclusion criteria. The median age of the participants at EI was 8.9 months. Eleven children had symptomatic UTIs (febrile, n = 9; recurrent non-febrile, n = 2) during the median follow-up of 75.5 months. Initial symptomatic UTI in each child occurred &lt;25 months after EI. The symptomatic UTI-free rate after EI was 65.6%. The risk factors for symptomatic UTI were female gender, duplex system, ectopic ureterocele, and unchanged hydronephrosis after EI.
Conclusions
The present study determined the critical period and risk factors for symptomatic UTI after EI for the treatment of ureterocele. The results suggest that when conservative management is indicated after EI, patients, especially those with risk factors, should be followed carefully at least for 25 months after EI for symptomatic UTI.

DOI： 10.1111/bju.13884

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

© 2017 Elsevier Inc. The lower urinary tract&#039;s main functions are storage and elimination. The micturition reflex pathway is modulated by the spinobulbospinal reflex pathway as well as higher brain centers involved in the voluntary micturition control. Micturition is sensitive to numerous injuries, resulting in various types of dysfunction. Animal studies indicate that lower urinary tract dysfunction partly depends on plasticity of the neural pathways. Reflex plasticity is associated with changes in ion channels, receptors, and numerous mediators. Animal models may aid in understanding the mechanisms leading to pathologic conditions and the plasticity in reflex pathways to the lower urinary tract after neurogenic lesions.

DOI： 10.1016/j.ucl.2017.04.014

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BioMed Central Ltd.  

Background: Ureterocalicostomy is indicated mainly in cases with failed pyeloplasty or with a completely intrarenal pelvis. While there have been several case series reported in adults, laparoscopic ureterocalicostomy in pediatric cases has rarely been reported. We report a case of pure laparoscopic ureterocalicostomy for ureteropelvic junction obstruction in an Asian female child. Case presentation: A 10-year-old female patient was referred to our hospital due to right high-grade hydronephrosis and a right renal stone, which was detected due to hematuria. Laparoscopic pyelolithotomy and ureterocalicostomy were indicated because of the completely intrarenal pelvis with thinning of the cortex, especially at the lower calyx. A transperitoneal approach was implemented in a lateral flank position with four trocars. After exposing the renal hilum, the renal stone was extracted without lithotripsy by making a small longitudinal incision at the ureteropelvic junction. Then, the ureter was transected, and the renal pelvis was closed. A 2-cm incision was made at the lower calyx. Uretero-caliceal anastomosis was completed in a running fashion using 5-0 absorbable sutures. The operation time was 379 min. The postoperative course was uneventful. Postoperative imaging studies showed marked improvement of the right hydronephrosis. Conclusion: Laparoscopic ureterocalicostomy is a safe and feasible treatment for selected patients with complicated ureteropelvic junction obstruction, even in the pediatric population.

DOI： 10.1186/s13104-017-2569-x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

Limited numbers of pediatric intratesticular cystic lesions have been reported. Although the majority of pediatric intratesticular cystic masses are benign, natural history of testicular cystic lesion in children has been rarely reported so far. We report a case of intratesticular cystic lesion in a prepubertal child who underwent testis sparing surgery after shrinkage during conservative follow-up. As an initial strategy for intratesticular cystic lesions in prepubertal children, observational approach with serial ultrasonographic evaluations may be a management of choice. (C) 2017 Elsevier Inc.

DOI： 10.1016/j.urology.2017.02.034

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY  

ObjectivesPressure flow studies are regarded as the gold standard for evaluating both bladder outlet obstruction and detrusor contractility, but none of the current methods for evaluating bladder contraction patterns are well validated. Impaired bladder contraction results in a lower peak Watts factor and poorly sustained detrusor contractions. From this viewpoint, the maximum Watts factor and its pattern should be considered separately. To examine detrusor contraction pattern in patients after radical prostatectomy by using multiple parameters.
MethodsA total of 37 patients with clinically localized prostate cancer underwent both pre- and post-radical prostatectomy urodynamic evaluations. The examined urodynamic parameters included the maximum flow rate, post-void residual volume, detrusor pressure at maximum flow, maximum Watts factor and relative volume (maximum Watts factor). Some parameters were defined from the Watts factor curve throughout micturition. Relative volume (maximum Watts factor) was the relative bladder volume at the maximum Watts factor. A normal detrusor contractility pattern involves an increase in Watts factor at the initiation followed by further gradual increases until the end of micturition.
ResultsMaximum flow rate increased significantly after radical prostatectomy (pre: 13.06.5, post: 17.3 +/- 7.7mL/min; P&lt;0.01), whereas detrusor pressure at maximum flow and post-void residual volume decreased significantly (pre: 49.6 +/- 21.6 and 31.4 +/- 18.2cmH(2)O; post: 48.6 +/- 66.1 and 10.1 +/- 28.5mL; P&lt;0.05). Maximum Watts factor did not change significantly after radical prostatectomy (pre: 10.5 +/- 3.1W/m(2), post: 11.0 +/- 3.2W/m(2)), but relative volume (maximum Watts factor) decreased significantly (pre: 0.48 +/- 0.3, post: 0.20 +/- 0.20; P&lt;0.001). Maximum Watts factor represents the maximum power of bladder contraction at a particular point in time, whereas relative volume (maximum Watts factor) can be used to detect changes in detrusor contraction pattern.
ConclusionsEvaluation of relative volume (maximum Watts factor) confirms that radical prostatectomy restores the normal detrusor contractility pattern in prostate cancer patients.

DOI： 10.1111/iju.13295

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記述言語：英語   出版者・発行元：ELSEVIER SCIENCE INC  

DOI： 10.1016/j.juro.2017.02.1135

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記述言語：英語   出版者・発行元：NATURE PUBLISHING GROUP  

The lower urinary tract is controlled by complex neural mechanisms not only in the periphery, but also in the central nervous systems (CNS). Thus, patients with a wide variety of neurological diseases often also have lower urinary tract symptoms (LUTS), including those with Parkinson disease (PD) or multiple system atrophy (MSA). LUTS are common comorbidities associated with both of these neurodegenerative diseases and are likely to impair patients' quality of life. The motor symptoms of PD and MSA often seem similar; however, the pathophysiology, and thus the treatment of LUTS differs considerably. Antimuscarinics are the first-line treatment of storage LUTS in patients with PD or MSA; however, care should be taken in the management of these patients, especially in those with MSA owing to the high risk of inefficient voiding, and thus an increased post-void residual volume. Other treatments of PD-related LUTS include a-adrenoceptor antagonists, which improve voiding dysfunction, transurethral resection of the prostate for bladder outlet obstruction owing to prostate enlargement, and neuromodulation and intradetrusor botulinum toxin injections for storage LUTS. However, more conservative treatments, including intermittent catheterization, are required for LUTS in patients with MSA, owing to the high incidence of impaired detrusor contractility and detrusor-sphincter dyssynergia.

DOI： 10.1038/nrurol.2016.254

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

Background. We investigated whether the age of donor kidneys influences the incidence of nocturnal polyuria in patients with successful renal transplantation (RTX).
Methods. Eighty-five patients (45 men and 40 women) undergoing RTX (median age, 47 years) were included in this study. Twenty-four-hour bladder diaries were kept for 3 days, and nocturnal polyuria was defined as a nocturnal polyuria index (nocturnal urine volume/24-hour urine volume) of &gt;0.33. Risk factors for nocturnal polyuria were analyzed in patients with RTX by means of the Mann-Whitney U test, chi(2) test, and a logistic regression analysis.
Results. End-stage renal disease (ESRD) developed from diabetes mellitus in 16 patients (19%). Sixty-five patients (76%) received pre-transplant dialysis, with a median duration of 5 years. The median serum creatinine level and body mass index at the most recent visit were 1.2 mg/dL and 21.2 kg/m(2), respectively. On the basis of the 24-hour bladder diaries, nocturnal polyuria was identified in 48 patients (56%). A logistic regression analysis revealed that diabetes mellitus as the original disease for ESRD was the only risk factor for nocturnal polyuria (odds ratio, 8.95; 95% confidence interval, 2.01-65.3; P = .0028). The age of donor kidneys at examination did not affect the incidence of nocturnal polyuria (P = .9402).
Conclusions. Nocturnal polyuria was not uncommon in patients with successful RTX. Diabetes mellitus as the original disease for ESRD was the only risk factor for nocturnal polyuria, whereas the age of donor kidneys at examination did not affect the incidence of nocturnal polyuria. Thus, nocturnal polyuria is caused by recipient factors but not donor factors.

DOI： 10.1016/j.transproceed.2016.10.016

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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DOI： 10.1002/nau.22843

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DOI： 10.1016/j.jpurol.2016.02.015

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DOI： 10.1111/iju.13160

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DOI： 10.1016/j.steroids.2016.06.009

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

ObjectivesTo investigate the effect of descending serotonergic and noradrenergic pathways on nociception in the lower urinary tract (LUT).
MethodsFemale Sprague-Dawley rats were used. Following intraperitoneal administration of Vehicle or Milnacipran (30mg/kg), which is one of serotonin-noradrenaline reuptake inhibitors (SNRI), 0.1% AA was infused into the bladder in normal (n=4, each) and spinal cord injury (SCI) (n=4, each) rats for 2h on consciousness, and c-Fos, 5-HT and DH were stained using immunohistochemistry at the L6 spinal cord as spinal areas associated with LUT.
ResultsIn SCI rats, 5-HT or DH-positive fibers were not observed at the L6 spinal cord, while there were many 5-HT and DH-positive fibers in normal rats. The total number of c-Fos-positive cells was significantly increased in SCI rats compared to Normal rats (209.47.1 in Normal, 336.4 +/- 28.9 in SCI, P &lt; 0.05), which indicated that interruption of supraspinal modulation enhances nocieptive transmission in the LUT. Regarding the effect of Milnacipran administration, the number of c-Fos-positive cells was significantly decreased at all region of the L6 spinal cord in normal rats (P &lt; 0.05), while this reduction was not observed in SCI rats. This result demonstrated that administration of SNRI attenuates nocieptive transmission in the LUT, indicating that 5-HT and noradrenaline work as mediators of endogenous analgesic mechanisms through the supraspinal descending pain pathways.
ConclusionsSupraspinal projections of descending serotonergic and noradrenergic pathways to the lower lumbar spinal cord modulate nocieptive transmission in the LUT. Administration of SNRI attenuates nocieptive transmission in the LUT, which could result from enhancement of modulating descending serotonergic and noradrenergic pathways.

DOI： 10.1111/luts.12085

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DOI： 10.1007/s00345-016-1763-0

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DOI： 10.1111/iju.13096

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

Purpose: In the current study we examined dynamic changes in neural activity of the anterior cingulate cortex and the midbrain periaqueductal gray during the micturition reflex in a Parkinson's disease model as well as the effects of direct stimulation of the anterior cingulate cortex on the micturition reflex.
Materials and Methods: Electrodes were inserted in the anterior cingulate cortex or the periaqueductal gray. The effects of intravenous administration of the adenosine A2A receptor antagonist ZM24138 on pelvic nerve evoked field potentials were examined. The effect of electrical stimulation of the anterior cingulate cortex was also examined.
Results: Rats with Parkinson's disease showed bladder overactivity as evidenced by a significant decrease in the intercontraction interval compared with sham operated rats. Intravenous administration of ZM24138 increased the intercontraction interval in both groups with the inhibitory effects greater in rats with Parkinson's disease. It dose dependently increased the amplitude of evoked potentials in the anterior cingulate cortex of rats with Parkinson's disease but not in sham operated rats. Intravenous administration of ZM24138 decreased evoked potential amplitude in the periaqueductal gray of both groups with the inhibitory effects greater in Parkinson's disease vs sham operated rats. Electrical stimulation of the anterior cingulate cortex significantly increased the intercontraction interval.
Conclusions: These results suggest that anterior cingulate cortex neurons have an inhibitory role in bladder control. Neural activity in the anterior cingulate cortex was significantly increased along with suppression of bladder overactivity after ZM241385 administration in the Parkinson's disease model and the stimulation of the anterior cingulate cortex inhibited the micturition reflex. Understanding the roles of the anterior cingulate cortex in the modulation of micturition could provide further insights into the pathophysiology of overactive bladder.

DOI： 10.1016/j.juro.2015.11.039

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1002/nau.22721

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：PUBLIC LIBRARY SCIENCE  

Sexually dimorphic brain development and behavior are known to be influenced by sex hormones exposure in prenatal periods. On the other hand, second-to forth digit ratio (2D/4D) has been used as an indirect method to investigate the putative effects of prenatal exposure to androgen. In the present study, we herein investigated the relationship between genderrole play behavior and the second-to-fourth digit ratio (2D/4D), which has been used as an indirect method to investigate the putative effects of prenatal exposure to androgens, in school-aged children. Among 4981 children who became 8 years old by November 2014 and were contactable for this survey by The Hokkaido Study of Environment and Children's Health, 1631 (32.7%), who had data for 2D/4D and Pre-school Activities Inventory (PSAI) as well as data for the survey at baseline, were available for analysis. Parents sent reports of PSAI on the sex-typical characteristics, preferred toys, and play activities of children, and black and white photocopies of the left and right hand palms via mail. PSAI consisted of 12 masculine items and 12 feminine items, and a composite score was created by subtracting the feminine score from the masculine score, with higher scores representing masculine-typical behavior. While composite scores in PSAI were significantly higher in boys than in girls, 2D/4D was significantly lower in boys than in girls. Although the presence or absence of brothers or sisters affected the composite, masculine, and feminine scored of PSAI, a multivariate regression model revealed that 2D/4D negatively correlated with the composite scores of PSAI in boys, whereas no correlation was found in girls. Although 2D/4D negatively correlated with the masculine score in boys and girls, no correlation was observed between 2D/4D and the feminine score. In conclusion, although social factors, such as the existence of brother or sisters, affect dimorphic brain development and behavior in childhood, the present study revealed that the prenatal hormonal environment was an important factor influencing masculine-typical dimorphic brain development and behavior in schoolaged children.

DOI： 10.1371/journal.pone.0146849

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

Aims: Stress urinary incontinence (SUI) is common in post-menopausal women. The present study therefore examined how aging and estrogen deficiency induced by ovariectomy (OVX) affect the urethral continence mechanism that prevents sneeze-induced SUI in rats. Methods: Young (3 months old) and middle-aged (12 months old) female rats underwent bilateral OVX or sham operation. Urethral activity was measured by the amplitude of urethral responses during sneezing (A-URS) and urethral baseline pressure (UBP). Apoptotic changes in urethral tissue sections were examined by the TUNEL method. Results: In middle-aged rats, UBP, but not A-URS, was significantly decreased compared to young rats. In 3-week OVX rats, A-URS was significantly decreased compared to sham rats in both young and middle-aged groups, and the OVX-induced reduction in A-URS was more pronounced in middle-aged rats. Neither young 3-week OVX nor sham rats leaked during sneezing; however, SUI occurred in 2/8 middle-aged rats with 3-week OVX, and after 6 weeks of OVX, SUI was observed in 5/8 young rats and 6/8 middle-aged rats. In middle-aged rats, TUNEL positive cells were significantly increased in urethral striated muscles whereas, after OVX, the increased number of positive cells was also found in the mucosa. Conclusions: These results indicate that aging is more likely to impair baseline urethral function than striated muscle-mediated reflex activity although apoptotic changes are found in urethral striated muscle. Estrogen deficiency additionally impairs the striated muscle-mediated continence reflex. Thus, aging and estrogen deficiency differently and additively affect baseline urethral function and neurally-evoked, striated muscle-mediated urethral continence mechanisms to induce SUI. (C) 2014 Wiley Periodicals, Inc.

DOI： 10.1002/nau.22690

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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DOI： 10.12659/AOT.895515

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DOI： 10.5980/jpnjurol.106.285

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

Purpose: We investigated the effect of duloxetine, a norepinephrine and serotonin reuptake inhibitor, on the sneeze induced continence reflex and on bladder function in rats with cerebral infarction.
Materials and Methods: Using urethane anesthesia the effect of duloxetine ( 1 mg/kg intravenously) on the amplitude of urethral responses during sneezing as well as urethral baseline pressure at the mid urethra was evaluated in normal female adult rats and cerebral infarction rats. Tilt leak point pressure was also measured. In normal and cerebral infarction rats continuous cystometry was evaluated before and after duloxetine injection.
Results: In cerebral infarction rats urethral baseline pressure was 43% lower than in normal rats but the amplitude of urethral responses during sneezing did not differ in the 2 groups. Duloxetine increased the amplitude of urethral responses during sneezing and urethral baseline pressure by 31% and 21%, respectively, in normal rats but did not affect either in cerebral infarction rats. Also, in cerebral infarction rats leak point pressure was 29% lower compared with normal rats. Duloxetine increased leak point pressure in normal rats but not in cerebral infarction rats. Cerebral infarction reduced intercontraction intervals without affecting the amplitude of bladder contractions compared with normal rats. Duloxetine prolonged intercontraction intervals in cerebral infarction rats but not in normal rats.
Conclusions: These results suggest that cerebral infarction induces not only bladder overactivity but also stress urinary incontinence, which may account for mixed incontinence in patients with cerebral infarction. After cerebral infarction duloxetine reduced bladder overactivity but failed to enhance active urethral closure mechanisms during sneezing, suggesting that disorganization of the brain network after cerebral infarction might influence the effect of duloxetine on lower urinary tract function.

DOI： 10.1016/j.juro.2015.03.091

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DOI： 10.1111/iju.12721

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DOI： 10.1016/j.juro.2014.08.007

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

ObjectivesTo assess the postoperative lower urinary tract function in patients undergoing pelvic organ prolapse surgery.
MethodsA total of 24 women with advanced anterior vaginal wall prolapse underwent transvaginal repair using a polypropylene mesh. The preoperative, 1-week and 3-month postoperative evaluations were carried out by urodynamics. Maximal flow rate detrusor pressure at maximal flow rate, voided volume and bladder contractility index were measured. A value of P&lt;0.05 was considered to be statistically significant.
ResultsThe mean age of patients was 73.5 years (range 49-84 years). The mean postoperative maximal flow rate, voiding efficiency and bladder contractility index decreased significantly after the operation compared with the preoperative values (P&lt;0.05). No significant differences were observed between preoperative and 3-month postoperative parameters. Of the patients, 33.3%, 11.1% and 50% were classified as having normal/strong contractility preoperative, 1 week and 3 months, respectively. The proportion of normal/strong contractility decreased significantly after the operation, and it recovered 3 months postoperatively. The grade of obstruction did not change significantly.
ConclusionsPatients undergoing pelvic organ prolapse surgery present temporary impaired detrusor contractility, which improves significantly during the midterm postoperative period.

DOI： 10.1111/iju.12656

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DOI： 10.1371/journal.pone.0120636

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

AimsAdenosine is a neurotransmitter that exerts numerous physiological effects in many organs. However, few studies have focused on the role of adenosine receptors in the control of micturition. Therefore, we examined the role of adenosine A1 and A2A receptors in the control of bladder activity in rats with normal or acetic acid (AA) irritated bladders.
MethodsCystometrograms during saline or 0.2% AA infusion were recorded under urethane anesthesia in female Sprague-Dawley rats. After a stabilization period, CCPA (A1 receptor agonist) and/or ZM24138 (A2A receptor antagonist) were administered intravenously (i.v.), intrathecally (i.t.), intracerebroventricularly (i.c.v.), or intravesically. Micturition parameters were recorded and compared before and after drug administration.
ResultsI.v., i.t., or i.c.v. administration of CCPA or ZM24138 significantly increased intercontraction intervals (ICIs) in both saline and AA infusion groups. During AA infusion, the inhibitory effects induced by i.c.v. CCPA or i.t. ZM24138 were significantly greater than those by i.t. or i.c.v. administration, respectively. Intravesical administration of CCPA, but not ZM24138, significantly increased ICI.
ConclusionsThese results indicated that: (1) when nociceptive signals from the bladder increase, adenosine A1 receptor-mediated inhibition of micturition is enhanced in the brain, compared to the normal condition, (2) A1 receptor activation also exerts a peripheral inhibitory effect on micturition, and (3) adenosine A2A receptor-mediated excitatory mechanisms are enhanced in the spinal cord following C-fiber bladder afferent stimulation. Thus adenosine A1 receptor agonists and A2A receptor antagonists might be effective for the treatment of overactive bladder and/or bladder hypersensitive disorders, in which C-fiber afferent function is enhanced. Neurourol. Urodynam. 33:1259-1265, 2014. (c) 2013 Wiley Periodicals, Inc.

DOI： 10.1002/nau.22487

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCI LTD  

Objective: To review laparoscopy in patients with disorders of sex development (DSD) in order to clarify its usefulness in diagnosis, devising subsequent therapeutic strategies and managing patients with various conditions.
Patients and methods: Between April 1992 and December 2012, 29 laparoscopic surgeries were performed in 25 DSD patients. Among them, ten were diagnostic laparoscopy including gonadal biopsy, and 19 were therapeutic laparoscopy. Surgical procedures and complications were evaluated.
Results: For diagnostic laparoscopy, laparoscopic gonadal biopsy was performed in three patients. Inspection, with or without open gonadal biopsy, was performed on four out of seven patients with 46XY DSD or mixed gonadal dysgenesis (MGD). Additional surgery was planned and performed based on diagnostic laparoscopic findings in six out of seven patients. In the three patients with ovotesticular DSD, the gonadal pathology was diagnosed as: testis/ovary in one, testis/ovotestis in one and ovary/ovotestis in one - this was from the laparoscopic inspection and/or gonadal biopsy. However, the final diagnoses were bilateral ovotestis in two patients and ovary/ovotestis in one patient.
For therapeutic laparoscopy, surgical procedures were: gonadectomy in 17 patients (bilateral in 13, unilateral in three, partial in two); hysterectomy in two patients; orchiopexy in one; and sigmoid vaginoplasty in one patient (included multiple procedures). There were no severe perioperative complications. In the four patients with a history of diagnostic laparoscopy, no severe intra-abdominal adhesions that would disturb therapeutic laparoscopic surgery were observed.
Conclusion: While diagnostic laparoscopy was helpful in devising a therapeutic surgical strategy in most of the patients with DSD who were suspected as having complex gonadal status or Mullerian duct derivatives, attention must be paid to precisely diagnosing the gonadal status in ovotesticular DSD. On the other hand, therapeutic laparoscopic surgeries were valuable procedures in treating DSD patients, even with a history of previous diagnostic laparoscopy. (C) 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.jpurol.2014.03.006

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

Objectives: To investigate the contribution of bone marrow-derived mesenchymal stem cells to the changes in bladder morphology in response to partial bladder outlet obstruction.
Methods: Allogenic bone marrow cells were transplanted from transgenic rats expressing green fluorescent protein into female Sprague-Dawley rats 1 day after their bone marrow-derived mesenchymal stem cells had been destroyed by irradiation. This generated chimeric rats in which green fluorescent protein labeled bone marrow-derived mesenchymal stem cells replaced host bone marrow-derived mesenchymal stem cells. The animals received partial bladder outlet obstruction or sham surgery 6 weeks later. The animals were killed 6 weeks after the surgery, and bladder tissue was prepared for immunofluorescence with antibodies against a urothelium marker (AE1/AE3), a myofibroblast marker (vimentin), a smooth muscle marker and green fluorescent protein.
Results: More labeled bone marrow-derived mesenchymal stem cells were found in the partial bladder outlet obstruction group than in the in the sham group. Most bone marrow-derived mesenchymal stem cells were present around the basement membrane (laminin) and lamina propria below the urothelium. Bone marrow-derived mesenchymal stem cells were also found in the urothelium layer, and some of them were double-stained with green fluorescent protein and AE1/AE3. Some bone marrow-derived mesenchymal stem cells, which were located in the interstitial tissue, were double-stained with green fluorescent protein and vimentin. Bone marrow-derived mesenchymal stem cells, which migrated into the smooth muscle layer, showed fusiform morphology, and some were double-stained with green fluorescent protein and smooth muscle marker.
Conclusions: Bone marrow-derived mesenchymal stem cells home to the partial bladder outlet obstruction bladder, and these cells have the potential to differentiate into the several components of bladder tissue including the urothelium, myofibroblasts and smooth muscle cells. Thus, bone marrow-derived mesenchymal stem cells contribute to the morphological changes of the bladder in response to partial bladder outlet obstruction.

DOI： 10.1111/iju.12406

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：NATURE PUBLISHING GROUP  

Objectives: We investigated relation of preoperative renal scar to incidence of postoperative metabolic acidosis following ileocystoplasty in patients with neurogenic bladder.
Patients: Thirty patients with neurogenic bladder, who underwent ileocystoplasty, were enrolled in the present study. Median age at ileocystoplasty was 13.9 years and median follow-up period after ileocystoplasty was 8.2 years. Metabolic acidosis was defined based on the outlined criteria: base excess (BE) is less than 0 mmol l (-1). Preoperative examination revealed that no apparent renal insufficiency was identified in blood analysis, although preoperative Tc-99m-DMSA scintigraphy indicated abnormalities such as renal scar in 14 patients (47%). Incidence of postoperative metabolic acidosis was compared between patients with and without preoperative renal scar, which may reflect some extent of renal tubular damage.
Results: Postoperative metabolic acidosis was identified in 13 patients (43%). Incidence of postoperative metabolic acidosis was significantly higher in patients with renal scar (11/14, 79%) compared with patients without renal scar (2/16, 13%; P&lt;0.01). Particularly, all eight patients who had bilateral renal scars showed metabolic acidosis postoperatively. Compared with patients without preoperative renal scar, pH (P&lt;0.05) and BE (P&lt;0.01) were significantly lower postoperatively in patients with preoperative renal scar. However, there was no significant difference in PCO2. Hyperchloremia was observed in each patient with or without preoperative renal scar.
Conclusion: Incidence of postoperative metabolic acidosis was significantly implicated in preoperative renal scar. If renal abnormalities are preoperatively identified in imaging tests, we need to care patients carefully regarding metabolic acidosis and subsequent comorbidities following ileocystoplasty.

DOI： 10.1038/sc.2013.175

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

Aims
The urethral continence reflex during stress conditions such as sneezing or coughing is an important mechanism preventing stress urinary incontinence (SUI). Although the spinal noradrenergic and serotonergic pathways are known to modulate this reflex activity, the role of spinal cholinergic pathways in the control of urethral continence reflex has not been elucidated. We therefore investigated the effect of intrathecal administration of an acetylcholine esterase (AChE) inhibitor, which increases ACh in synaptic terminals, and anti-cholinergic agents on the sneeze-induced urethral reflex in rats.
Methods
Female SD rats were anesthetized with urethane. Urethral function was evaluated during sneezing induced by insertion of the rat whisker into the nostril. Effects of an AChE inhibitor, neostigmine, and muscarinic or nicotinic receptor antagonists administered at the level of L6-S1 spinal cord were examined.
Results
Neostigmine dose-dependently and significantly decreased the amplitude of urethral responses during sneezing (A-URS) with an approximately 70% reduction at 3 nmol, without changing urethral baseline pressure. The neostigmine-induced decrease in A-URS was significantly reversed by pretreatment with atropine (nonselective muscarinic receptor antagonist), methoctramine (M2 receptor antagonist) or 4-DAMP (M3 receptor antagonist), but not with pirenzepine (M1 receptor antagonist), tropicamide (M4 receptor antagonist), or mecamylamine (nicotinic receptor antagonist).
Conclusions
These results indicate that an increase in endogenous ACh in the lumbosacral spinal cord inhibits the sneeze-induced urethral continence reflex via activation of M2 and/or M3-muscarinic receptors, implying the inhibitory role of spinal cholinergic pathways in the control of urethral continence reflex under stress conditions such as sneezing. Neurourol. Urodynam. 33:443-448, 2014. (c) 2013 Wiley Periodicals, Inc.

DOI： 10.1002/nau.22431

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

This article summarizes anatomical, neurophysiological, and pharmacological studies in humans and animals to provide insights into the neural circuitry and neurotransmitter mechanisms controlling the lower urinary tract and alterations in these mechanisms in lower urinary tract dysfunction. The functions of the lower urinary tract, to store and periodically release urine, are dependent on the activity of smooth and striated muscles in the bladder, urethra, and external urethral sphincter. During urine storage, the outlet is closed and the bladder smooth muscle is quiescent. When bladder volume reaches the micturition threshold, activation of a micturition center in the dorsolateral pons (the pontine micturition center) induces a bladder contraction and a reciprocal relaxation of the urethra, leading to bladder emptying. During voiding, sacral parasympathetic (pelvic) nerves provide an excitatory input (cholinergic and purinergic) to the bladder and inhibitory input (nitrergic) to the urethra. These peripheral systems are integrated by excitatory and inhibitory regulation at the levels of the spinal cord and the brain. Therefore, injury or diseases of the nervous system, as well as disorders of the peripheral organs, can produce lower urinary tract dysfunction, leading to lower urinary tract symptoms, including both storage and voiding symptoms, and pelvic pain. Neuroplasticity underlying pathological changes in lower urinary tract function is discussed.

DOI： 10.4111/kju.2014.55.2.81

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

BackgroundThe functions of the lower urinary tract, to store and periodically release urine, are dependent on the activity of smooth and striated muscles in the urinary bladder, urethra, and external urethral sphincter. This activity is in turn controlled by neural circuits in the brain, spinal cord, and peripheral ganglia.
AimsThis paper will review recent advances in our understanding of the pathophysiology of voiding disorders, especially focusing on the central nervous system.
MethodsVarious neurotransmitters, including acetylcholine, norepinephrine, dopamine, serotonin, excitatory and inhibitory amino acids, adenosine triphosphate, nitric oxide, and neuropeptides, have been implicated in the neural regulation of the lower urinary tract.
ResultsInjuries or diseases of the nervous system, as well as drugs and disorders of the peripheral organs, can produce voiding dysfunctions such as urinary frequency, urgency, or incontinence.
ConclusionWe discuss the potential targets in the central nervous system and new modalities for the treatment of voiding dysfunction. Neurourol. Urodynam. 33:59-66, 2014. (c) 2013 Wiley Periodicals, Inc.

DOI： 10.1002/nau.22455

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/iju.12529

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Introduction and hypothesis: Anticholinergics are used to treat overactive bladder. Anticholinergic agents such as propiverine hydrochloride reportedly increase plasma catecholamine levels in rats. It is also known that active urethral closure mechanisms prevents stress urinary incontinence (SUI), which is enhanced by central and peripheral noradrenergic system activation. Therefore, we examined the influence of propiverine hydrochloride on urethral anti-incontinence function in rats. Methods: Adult female rats were divided into propiverine and vehicle-treated groups. The propiverine group was given propiverine orally once a day for 2 weeks, after which urethral function and plasma concentrations of catecholamine (dopamine, norepinephrine, epinephrine) were tested. Results: Urethral baseline pressure measured by a microtransducer-tipped urethral catheter and leak-point pressure during passive intravesical pressure elevation were significantly increased in the propiverine group compared with the vehicle group. Plasma norepinephrine and epinephrine levels in the propiverine group were also significantly increased. Conclusions: Propiverine treatment that increases plasma catecholamine levels could contribute to improvement of SUI conditions by increasing urethral resistance. © 2012 The International Urogynecological Association.

DOI： 10.1007/s00192-012-1924-7

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/iju.12007

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/j.1442-2042.2012.03156.x

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

The periaqueductal gray (PAG) is known to be a crucial region underlying regulation of not only the nociception but also the micturition reflex. Several reports have shown that glutamate (Glu) and/or serotonin (5-HT) neurotransmissions are involved in these mechanisms, however, few attempts have been addressed to examine the dynamic changes in these two neurotransmitters in the PAG. The aim of the present study is to elucidate whether PAG Glu and/or 5-HT levels are influenced by acetic acid (AA)induced cystitis of freely moving rats using an in vivo microdialysis. Male Wistar rats were used. A dialysis probe was inserted into the PAG via a guide cannula which was stereotaxically implanted. Saline or 0.1%-AA was continuously infused into the bladder through a catheter at a rate of 0.2 ml/min for 30 min. Extracellular levels of Glu and 5-HT were measured. Glu levels increased slightly in the saline-infused controls. In the AA-induced cystitis model, remarkable increases in Glu levels were observed and this improvement was sustained for up to 180 min after infusion. 5-HT levels also increased, but these gradually recovered to the basal levels after infusion of AA. The present data suggest that sustained increases in Glu levels might be related to pain suppression by PAG activation during cystitis, whereas increases in 5-HT levels seem to reflect the early phase by nociceptive stimuli. In other words, enhancement of endogenous Glu levels in the PAG may be in part attributable to the modulation of both the nociceptive mechanism and the micturition reflex.

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

Objectives: We investigated the time course of the stromal cell-derived factor 1a (SDF1a) expression and behavior of intravenously administered bone marrow-derived stromal (BMS) cells in the urinary bladder of partial bladder outlet obstruction (PBOO) rats. Methods: Study 1: Recombinant SDF1a or saline was directly injected into the bladder wall of female rats followed by intravenous administration of BMS cells isolated from green fluorescent protein (GFP) transgenic rats. The bladder was examined with immunohistochemistry to determine whether SDF1a would enhance migration of BMS cells to the bladder. Study 2: Following surgery of PBOO or sham in female rats, bladders were removed on days 114, and expression of hypoxia inducible factor 1a (HIF1a) and SDF1a were examined with real-time polymerase chain reaction (PCR) to determine if PBOO preferentially increased their expression. Study 3: Female rats underwent PBOO or sham surgery followed by intravenous administration of GFP-positive BMS cells. Bladders were examined with immunohistochemistry on days 114 to determine whether BMS cells preferentially accumulated in the bladder. Results: BMS cells were accumulated in the injection site of SDF1a but not saline in the bladder. SDF1a and HIF1a increased at day 1 after PBOO compared to sham. More BMS cells accumulated in the bladder of PBOO on day 1, and some BMS cells expressed smooth muscle phenotypes by day 14. Conclusion: SDF1a induced with ischemia/hypoxia due to PBOO is implicated in the accumulation of BMS cells in the bladder and regeneration of the bladder for PBOO.

DOI： 10.1111/j.1757-5672.2012.00153.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

Purpose: Overactive bladder is highly prevalent among patients with Parkinson disease. Adenosine is an important neurotransmitter in the central nervous system but it is not fully clarified how adenosine receptors regulate the micturition reflex. Thus, we examined the effect of an adenosine A2A receptor antagonist on the micturition reflex in a rat model of Parkinson disease.
Materials and Methods: In a rat model of Parkinson disease induced by 6-hydroxydopamine (Tocris Bioscience, Ellisville, Missouri) injection we examined the effects of the adenosine A2A receptor antagonist ZM241385, the dopamine D1 receptor agonist SKF38393 and the dopamine D2 receptor agonist quinpirole on bladder activity.
Results: Intravenous administration of ZM241385 increased the intercontraction interval in a dose dependent manner in rats with Parkinson disease and sham operated rats but the inhibitory effect was greater in the Parkinson disease group. Intrathecal and intracerebroventricular administration of ZM241385 increased the intercontraction interval in each group. However, in rats with Parkinson disease the inhibitory effects induced by intracerebroventricular administration of ZM241385 were greater than in sham operated rats. Intravenous administration of SKF38393 increased the intercontraction interval in rats with Parkinson disease and subsequent administration of ZM further increased the intercontraction interval. However, SKF38393 did not increase the intercontraction interval after ZM241385 application. Also, ZM241385 increased the intercontraction interval without being affected by pre-administration or post-administration of quinpirole, which decreased the intercontraction interval.
Conclusions: Results indicate that the adenosine A2A receptor mediated excitatory mechanism is enhanced at a supraspinal site to induce bladder overactivity and A2A receptor inhibition effectively suppresses bladder overactivity in rats with Parkinson disease. Thus, adenosine A2A receptor antagonists could be useful for bladder dysfunction in Parkinson disease cases.

DOI： 10.1016/j.juro.2011.12.062

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

Purpose: Stress urinary incontinence is often seen in postmenopausal women but limited information is available on hormone dependent changes of urethral function. Thus, we examined how ovariectomy and estrogen replacement affect urethral continence mechanisms.
Materials and Methods: In female nulliparous Sprague-Dawley (R) rats under urethane anesthesia after ovariectomy with or without estrogen replacement we measured urethral response amplitude during sneezing, urethral baseline pressure and sneeze induced leak point pressure. Whole urethras were tested for ex vivo urethral properties.
Results: Urethral response amplitude during sneezing was significantly decreased in 3 and 6-week ovariectomized rats. Urethral baseline pressure was significantly decreased only in 6-week ovariectomized rats. After estrogen replacement urethral baseline pressure but not urethral response amplitude during sneezing was significantly increased. Neither 3-week ovariectomized nor sham operated rats leaked during sneezing but fluid leakage was observed in 63% of 6-week ovariectomized rats. Estrogen replacement decreased the stress urinary incontinence incidence to 25%. Ex vivo testing revealed a significant increase in middle urethral compliance and a decrease in beta stiffness at the proximal and middle urethras in 6-week ovariectomized rats.
Conclusions: Results indicate that ovariectomy significantly impairs urethral function from the early stage (3 weeks) but does not induce stress urinary incontinence until the late stage (6 weeks). Also, estrogen replacement restores only the urethral baseline pressure parameter, leading to partial prevention of stress urinary incontinence. Since urethral baseline pressure and urethral response amplitude during sneezing parameters are related to urethral smooth and striated muscle activity, respectively, based on our previous studies, hormone replacement therapy may be partially effective for stress urinary incontinence by enhancing smooth muscle mediated urethral activity under stress conditions such as sneezing.

DOI： 10.1016/j.juro.2011.05.045

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1002/nau.21158

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

Purpose: Serotonin and norepinephrine reuptake inhibitors such as duloxetine have clinical efficacy for stress urinary incontinence. However, the therapeutic dose of duloxetine is often associated with unwanted side effects. We examined whether combined alpha(2)-adrenoceptor antagonists could decrease the duloxetine dose due to synergistic effects.
Materials and Methods: We used normal female rats and rats with stress urinary incontinence induced by vaginal distention. Urethral responses were measured using a microtransducer tipped catheter. We evaluated the effect of low dose duloxetine (0.1 mg/kg), alpha(2)-adrenoceptor antagonists (idazoxan or yohimbine) and sequential administration of drugs on urethral pressure response amplitude during sneezing and urethral baseline pressure. Sneeze induced leak point pressure was also measured.
Results: In normal and vaginally distended rats low dose duloxetine did not alter urethral pressure response amplitude during sneezing but it significantly increased urethral baseline pressure. When low dose duloxetine was co-applied with alpha(2)-adrenoceptor antagonists, urethral pressure response amplitude during sneezing was significantly increased. In all 7 vaginally distended rats leakage was observed during sneezing. After low dose duloxetine administration fluid leakage still occurred during sneezing. However, after low dose duloxetine and idazoxan co-administration fluid leakage disappeared in 2 of 7 rats and sneeze induced leak point pressure was significantly increased in the remaining incontinent rats with vaginal distention.
Conclusions: Findings support the concept that combination therapy with alpha(2)-adrenoceptor antagonists may be an effective, novel strategy to reinforce the clinical efficacy of serotonin and norepinephrine reuptake inhibitors for stress urinary incontinence.

DOI： 10.1016/j.juro.2010.03.106

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

To clarify the role of spinal serotonergic mechanisms in preventing stress urinary incontinence (SUI) during sneezing, we investigated the effect of intrathecal (it) application of 8-OH-DPAT (a 5-HT(1A) agonist), mCPP (a 5-HT(2B/2C) agonist), and fluoxetine (a serotonin reuptake inhibitor) using a rat model that can examine the neurally evoked continence reflex during sneezing. Amplitudes of urethral pressure responses during sneezing (A-URS), urethral baseline pressure (UBP) at the midurethra, and sneeze-induced leak point pressure (S-LPP) were measured in normal female adult rats and rats with SUI induced by vaginal distention (VD). In normal rats, 8-OH-DPAT decreased A-URS by 48.9%, whereas mCPP increased A-URS by 33.6%. However, A-URS was not changed after fluoxetine. 8-OH-DPAT, mCPP, or fluoxetine did not alter UBP. The effect of 8-OH-DPAT and mCPP was antagonized by WAY-100635 (it), a selective 5-HT(1A) antagonist, and RS-102221 (it), a selective 5-HT(2C) antagonist, respectively. Fluoxetine in the presence of WAY-100635 did not change either A-URS or UBP, but fluoxetine in the presence of RS-102221 decreased A-URS. In VD rats, S-LPP was decreased by 14.6 cmH2O after 8-OH-DPAT, whereas it was increased by 12.8 cmH2O after mCPP. However, S-LPP was not changed after fluoxetine. These results indicate that activation of 5-HT(2C) receptors enhances the active urethral closure reflex during sneezing at the spinal level, whereas 5-HT(1A) inhibits it and that no apparent changes in the sneeze-induced continence reflex after fluoxetine treatment are due to coactivation of excitatory 5-HT(2C) receptors and inhibitory 5-HT receptors other than the 5-HT(1A) subtype. Thus, activation of excitatory 5-HT receptor subtypes such as 5-HT(2C) could be effective for the treatment of SUI.

DOI： 10.1152/ajprenal.00297.2009

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

To evaluate the effects of orally administered YM976, a specific inhibitor of type 4 phosphodiesterase (PDE4), on bladder activity in a rat model with hydrochloric acid (HCl)-induced cystitis (IC), hypothesizing that a PDE4 inhibitor might suppress bladder overactivity and bladder pain responses in bladder-hypersensitive disorders such as IC.
Wistar rats with HCl-induced IC were treated with YM976 or vehicle and their voiding observed and assessed by cystometry. The severity of bladder inflammation (BI) was quantified using the BI index (BII), which comprises three factors (oedema, leukocyte infiltration and haemorrhage). Nociceptive neural activity was also examined using an immunohistochemical study of spinal c-fos expression.
YM976 significantly reduced the number of voids, and the volume per void was significantly higher than in control (vehicle) group. Cystometry showed a significant increase in bladder capacity, voided volume and voiding efficiency, and a decrease in the amplitude of voiding pressure in rats treated with YM976. All BII scores were significantly lower in the YM976 than in the control group. c-fos expression in the spine was less in the YM976 than in the control group.
Oral administration of YM976 significantly improved the voiding behaviour and histological damage in rats with IC induced by HCl. These results indicate that PDE4 inhibitor might be effective in relieving bladder symptoms with IC.

DOI： 10.1111/j.1464-410X.2008.07662.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

Purpose: We investigated the correlations between ultrasonographic bladder wall thickness and urodynamic parameters, and estimated the diagnostic accuracy of bladder wall thickness for predicting unfavorable urodynamic patterns in children with myelodysplasia.
Materials and Methods: A total of 57 children (median age 5.1 years.) with myelodysplasia were enrolled in the study. All children underwent ultrasonography to measure bladder wall thickness. Videourodynamic evaluation was also performed within 3 months of ultrasound assessment. Bladder wall thickness was compared to urodynamic data. A urodynamic risk of upper urinary tract deterioration was defined as maximum detrusor pressure greater than 40 cm H2O during filling or at leakage, or sphincter dyssynergia during voiding.
Results: Bladder wall thickness was significantly correlated to detrusor leak point pressure, maximum amplitude of detrusor overactivity and maximum detrusor pressure during storage phase. In 16 children who had unfavorable urodynamic risk patterns the mean bladder wall thickness was 3.9 +/- 1.0 mm, compared to 2.4 +/- 0.7 mm. in 41 patients with favorable urodynamic patterns. There was a significant difference between bladder wall thickness in children with and those without urodynamic risk factors (p &lt; 0.001). For a diagnosis of unfavorable urodynamic patterns bladder wall thickness greater than 3.3 mm had a positive predictive value of 85.7%, a negative predictive value of 90.7%, specificity of 75.0% and sensitivity of 95.1%. Receiver operator characteristic analysis revealed that bladder wall thickness had a high predictive value for unfavorable urodynamic patterns, with an area under the curve of 0.908.
Conclusions: Ultrasonographic assessment of bladder wall thickness is a sensitive screening tool for the diagnosis of urodynamic risk factors for upper urinary tract deterioration in children with myelodysplasia.

DOI： 10.1016/j.juro.2008.03.062

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

The periaqueductal gray (PAG) is critically involved in the micturition reflex, but little is known about the neuronal mechanisms involved. The present study elucidated dynamic changes in dopamine (DA), glutamate and gamma-aminobutyric acid (GABA) in the rat PAG during the micturition reflex, with a focus on dopaminergic modulation using in vivo microdialysis combined with cystometrography. Extracellular levels of DA and glutamate increased, whereas levels of GABA decreased, in parallel with the micturition reflex. Application of a D-1 receptor antagonist into the PAG produced increases in maximal voiding pressure (MVP) and decreases in intercontraction interval (ICI), suggesting that the micturition reflex was facilitated by D-1 receptor blockade. The D-1 receptor antagonist prevented micturition-induced decreases in GABA efflux but had no effect on DA or glutamate. Neither a D-2 receptor antagonist nor a D-1/D-2 receptor agonist affected these neurochemical and physiological parameters. Micturition-induced inhibition of GABA was not observed in 6-hydroxydopamine (6-OHDA)-lesioned rats, an animal model of Parkinson's disease. 6-OHDA-lesioned rats exhibited bladder hyperactivity evaluated by increases in MVP and decreases in ICI, mimicking facilitation of the micturition reflex induced by D-1 receptor blockade. These findings suggest that the micturition reflex is under tonic dopaminergic regulation through D-1 receptors, in which a GABAergic mechanism is involved. Bladder hyperactivity observed in 6-OHDA-lesioned rats may be caused by dysfunction of GABAergic regulation underlying the micturition reflex. The present findings contribute to our understanding not only of the neurophysiology of the micturition reflex but also of the pathophysiology of lower urinary tract dysfunction in patients with Parkinson's disease.

DOI： 10.1111/j.1460-9568.2008.06276.x

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE BV  

Synaptic plasticity expressed as long-term potentiation (LTP) in the hippocampal-medial prefrontal cortex (mPFC) pathway is considered to be involved in cognitive function and learning and memory processes, but its synaptic mechanism remains unknown. The present study characterized LTP in the mPFC using the atypical antipsychotic clozapine, with a focus on dopaminergic modulation. The magnitude of LTP was facilitated by pretreatment with clozapine (20 mg/kg, i.p.), but not by the typical antipsychotic haloperidol (1 mg/kg, i.p.). Clozapine-induced LTP augmentation was blocked by the dopamine D, receptor antagonist SCH-23390 (10 mu g/rat, i.c.v.), but not by the D-2 receptor antagonist remoxipride (10 mu g/rat, i.c.v.) or the 5-HT1A receptor antagonist WAY-100635 (20 mu g/rat, i.c.v.). SCH-23390 (10 gg/rat, i.c.v.) by itself did not affect LTP induction. The D-1 receptor agonist SKF-38393 (10 mu g/kg, i.c.v.) facilitated LTP, mimicking the clozapine-induced response. Furthermore, in vivo microdialysis showed that transient increases in mPFC dopamine levels induced by tetanic stimulation sustained facilitation following clozapine administration (20 mg/kg, i.p.). These results demonstrate the importance of the D, receptor as a mediator of clozapine-induced LTP augmentation through enhanced dopaminergic activity. Augmentation of synaptic plasticity in the hippocampal-mPFC pathway via D, receptors appears to be responsible for the therapeutic effects of clozapine. (c) 2007 Elsevier B.V. All rights reserved.

DOI： 10.1016/j.brainres.2007.12.010

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

Purpose: Although there are some reports of the functional outcome after hypospadias surgery, long-term patient reported data on urinary symptoms are sparse. We evaluated the long-term outcome of urinary control in patients with hypospadias who were operated in childhood.
Materials and Methods: A detailed questionnaire was mailed to 33 patients with hypospadias who were between 18 and 26 years old and had undergone the first operation at age 6 years or younger, and to 50 age matched controls.
Results: A total of 22 patients (66.7%) and 38 controls (76.0%) returned the questionnaire. Mean age was 20.6 years in the hypospadias group and 21.0 years in the control group. Of the 22 patients 8 had mild and 11 had severe hypospadias, while severity was unknown in 3. Straight direction of the urinary stream was noted at a similar rate in the hypospadias and control groups (77% and 71%, respectively). Regarding the urinary stream, no subjects in either group reported it as bad or very bad. Of the hypospadias group 95% of subjects and 89% of controls reported mild or no urinary frequency bother. The incidence of individuals who always or mainly voided while standing was similar in the hypospadias and control groups (91% and 84%, respectively). However, 32% of subjects in the hypospadias group reported moderate or severe terminal dribbling, in contrast to only 3% of controls. When subjects with mild and severe hypospadias were compared, 4 of 11 (36%) with severe hypospadias needed to squeeze the urethra after voiding to eliminate residual urine in the urethra, whereas none with mild hypospadias needed to squeeze the urethra.
Conclusions: Although patients with hypospadias mostly have good urinary control, terminal dribbling is not uncommon, especially in those with severe hypospadias.

DOI： 10.1016/j.juro.2007.03.176

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL PUBLISHING  

To explore the possible involvement of alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionate (AMPA) glutamate-receptors in bladder dysfunction associated with bladder outlet obstruction (BOO), as detrusor overactivity (DO) is common in men with benign prostatic hyperplasia.
Proposed mechanisms of DO include the myogenic or neurogenic theory, and the autonomous bladder hypothesis. In rats, BOO produces premicturition contractions (PMCs) that are assumed to be a consequence of inappropriate non-micturition activity during the filling phase. Using pharmacology, we explored the cause of PMCs to provide new insights into DO in humans. BOO was created in female Wistar rats; 6 weeks after obstruction we evaluated them using conscious-filling cystometry. A specific AMPA receptor antagonist, 1-(4'-aminophenyl)- 3,5-dihydro-7,8-dimethoxy-4H-2,3-benzodiazepin-4-one (CFM-2) was administered intravenously (i.v.) (0.003-3 mg/kg) or intrathecally (i.t.) (0.01-10 mu g).
The i.v. administration of CFM-2 in rats with BOO significantly decreased the threshold pressure and micturition pressure. The most remarkable findings were that i.v. administration of CFM-2 in rats with BOO significantly and dose-dependently decreased the amplitude and number of PMCs. The highest dose of CFM-2 almost completely eliminated PMCs. The i.t. administration of CFM-2 had no significant effect on PMCs.
AMPA receptors have never been suggested as a neural mechanism of bladder dysfunction associated with BOO. Although PMCs in rats with BOO have been assumed to be mainly of myogenic origin, PMCs were suppressed by the i.v. administration of CFM-2. Thus, we think that PMCs have neurogenic components that are linked with AMPA receptors. In the present study, i.v. but not i.t. administration of CFM-2 suppressed PMCs, suggesting peripheral and/or supraspinal sites of inhibitory action of CFM-2 on PMCs.

DOI： 10.1111/j.1464-410X.2007.06919.x

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

Purpose: Even if performed early in life, hypospadias surgery may have a significant impact on self-esteem and sexual behavior in adolescence. We evaluated the long-term cosmetic and sexual outcomes of hypospadias surgery performed in childhood.
Materials and Methods: A detailed questionnaire was mailed to 33 patients with hypospadias who were 18 to 26 years old and had undergone the first operation at age 6 years or younger. It was also mailed to 50 age matched controls.
Results: A total of 22 patients (66.7%) and 38 controls (76.0%) returned the questionnaire. Mean age in the hypospadias and control groups was 20.6 and 21.0 years, respectively. Eight of the 22 patients had mild hypospadias and 11 had severe hypospadias. Severity was unknown in 3 patients. Age at the first and final operations was 31 to 75 (mean 46) and 35 to 81 months (mean 53). The number of operation was 1 in 10 patients, 2 in 10 and 3 in 2. The rate of dissatisfaction with penile appearance was slightly higher in the hypospadias group than in the control group (40.9% vs 34.2%). The single reason for dissatisfaction in the hypospadias group was inadequate penile size, whereas in the control group penile size, phimosis and curvature were the major reasons for dissatisfaction (69.2%, 46.2% and 23.1%, respectively). Experience with masturbation (100% and 97.4%) and sexual intercourse (52.4% and 55.3%), and mean age at first masturbation (13.4 and 13.0 years) and first sexual intercourse (16.6 and 17.3 years) were similar in the hypospadias and control groups, respectively.
Conclusions: Although patients with hypospadias had a slightly higher rate of dissatisfaction with penile size, their sexual behavior was not different from that in control subjects.

DOI： 10.1016/S0022-5347(06)00600-8

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出版者・発行元：3 Pt 1  

DOI： 10.1016/S0022-5347(05)00324-1

PubMed

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL PUBLISHING ASIA  

We report on a case of a pure urogenital sinus anomaly presented with bladder distention. A seven-day-old girl with an abdominal distension was referred to the Division of Urology, Hakodate Central Hospital, Hakodate, Japan. A common urogenital sinus without abnormalities in the labium, clitoris or anus was found. A computed tomography (CT) scan documented a distended bladder without hydrometrocolpos or hydroureteronephrosis. Cystography performed at 44 days revealed a large flaccid bladder without ureteral reflux. Urinary management by an indwelling urethral catheter was maintained until 3 months, when an endoscopic examination was performed and a stenotic urethral-type urogenital sinus with low confluence was diagnosed. Parents successfully instituted clean intermittent catheterization as a temporary urinary management, and postvoid residual urine gradually decreased. At 2 years of age, flap vaginoplasty was performed. In an urodynamic study performed postoperatively, the detrusor pressure during voiding was 40-50 cm H2O. The patient maintained spontaneous voiding without consequences. Appropriate urinary care is essential to prevent urological complications in cases with a pure urogenital sinus anomaly.

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   出版者・発行元：函館中央病院  

29歳女.慢性腎不全の診断で腹膜透析を開始した.57歳の叔父から左腎の提供を受けて生体腎移植術を施行した.免疫抑制導入剤としてtacrolimus,mycophenolate mofetil,prednisoloneの三剤を併用した.術後経過は順調で,移植後1ヵ月のプロトコール移植腎生検で拒絶及び免疫抑制剤の毒性は認めなかった.術後39日に退院した.術後43日に下痢,嘔吐の消化器症状が出現し,再入院した.その後咳嗽,暗痰排出等の呼吸器症状が出現した.術後50日に胸部単純写真で両上肺野に一つずつ腫瘤が認められた.病理結果と急速に進行している臨床経過とを重ね合わせ肺膿瘍と診断された.免疫抑制剤の減量を行い,ユナシンS及びバクタの投与を開始した.腫瘤は投与開始後速やかに縮小・鏡面形成・空洞化し呼吸器症状も改善した.抗生剤投与後27日に退院となった.現在生体腎移植術より約1年が経過,現在もCMV抗体価は1024倍と高値が継続しているが,外来にて経過観察中である

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   著書種別：学術書

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記述言語：日本語  

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記述言語：日本語   著書種別：学術書

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記述言語：日本語   著書種別：学術書

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記述言語：英語   著書種別：教科書・概説・概論

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記述言語：日本語   著書種別：学術書

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記述言語：日本語   著書種別：学術書

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記述言語：日本語   著書種別：学術書

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記述言語：日本語   著書種別：学術書

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記述言語：日本語   著書種別：学術書

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記述言語：日本語   著書種別：学術書

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記述言語：日本語   著書種別：学術書

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記述言語：日本語   著書種別：学術書

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記述言語：日本語   著書種別：学術書

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記述言語：日本語   著書種別：学術書

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記述言語：日本語   著書種別：学術書

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記述言語：日本語  

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記述言語：日本語   著書種別：学術書

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記述言語：日本語   著書種別：学術書

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記述言語：日本語   著書種別：学術書

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記述言語：日本語   著書種別：学術書

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記述言語：日本語   著書種別：学術書

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記述言語：日本語  

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記述言語：日本語   著書種別：学術書

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記述言語：日本語   著書種別：学術書

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記述言語：日本語   著書種別：学術書

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記述言語：日本語   著書種別：学術書

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記述言語：日本語   著書種別：学術書

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器科学会総会事務局  

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記述言語：日本語   出版者・発行元：(一社)日本排尿機能学会  

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記述言語：日本語   出版者・発行元：(一社)日本排尿機能学会  

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記述言語：日本語   出版者・発行元：(一社)日本排尿機能学会  

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記述言語：日本語   出版者・発行元：(一社)日本排尿機能学会  

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記述言語：日本語   出版者・発行元：(一社)日本排尿機能学会  

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記述言語：日本語   出版者・発行元：(一社)日本排尿機能学会  

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記述言語：日本語   出版者・発行元：(公社)日本理学療法士協会  

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記述言語：日本語   出版者・発行元：(株)メディカ出版  

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記述言語：日本語   掲載種別：研究発表ペーパー・要旨（全国大会，その他学術会議）   出版者・発行元：医学図書出版(株)  

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記述言語：日本語   出版者・発行元：医学図書出版(株)  

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記述言語：日本語   出版者・発行元：(一社)日本排尿機能学会  

骨盤底筋トレーニング(Pelvic floor muscle training、以下PFMT)は、尿失禁を有する患者を対象に、その症状軽減を目的に実施される筋力トレーニングである。尿禁制維持の役割を持つ骨盤底筋は骨格筋であり、加齢に伴って筋力が低下し、尿失禁につながることが考えられている。高齢者に対する保存療法に関する研究では、PFMTと全身的なエクササイズ、あるいはトイレ誘導と組合せた介入においては、症状軽減及びQOL改善を認めた報告があった。しかし論文数が少なく、今後さらなるエビデンス構築が必要であると考える。(著者抄録)

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記述言語：日本語   出版者・発行元：医学図書出版(株)  

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記述言語：日本語   出版者・発行元：(一社)日本老年医学会  

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記述言語：日本語   出版者・発行元：日本老年泌尿器科学会  

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記述言語：日本語   出版者・発行元：医学図書出版(株)  

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記述言語：日本語   出版者・発行元：医学図書出版(株)  

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記述言語：日本語   出版者・発行元：医学図書出版(株)  

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記述言語：英語  

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記述言語：日本語   出版者・発行元：日本老年泌尿器科学会  

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記述言語：日本語   出版者・発行元：日本老年泌尿器科学会  

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記述言語：日本語   出版者・発行元：日本老年泌尿器科学会  

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器科学会総会事務局  

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器科学会総会事務局  

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器科学会総会事務局  

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器科学会総会事務局  

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記述言語：日本語   掲載種別：研究発表ペーパー・要旨（全国大会，その他学術会議）   出版者・発行元：公益社団法人 日本理学療法士協会  

&lt;p&gt;【目的】&lt;/p&gt;&lt;p&gt;腹圧性尿失禁(SUI)は,腹圧の上昇により膀胱内圧が尿道閉鎖圧を上回ることで生じる.尿禁制は,骨盤底の支持構造による尿道の圧迫により維持される.近年,尿道圧迫に関与する能動的な支持は,骨盤底筋(PMF)の収縮に加え,内腹斜筋などの体幹深層筋の共同収縮が重要であるとされる.しかし既報では,背臥位や座位での検討であり,腹圧が上昇する肢位での報告は少ない.本研究の目的は,背臥位と中腰位でのPFM筋力と体幹筋における筋活動の違いについて検討することである.&lt;/p&gt;&lt;p&gt;【方法】&lt;/p&gt;&lt;p&gt; 対象は健常成人女性15名(年齢25.0歳,BMI 20.9(中央値))とした.測定肢位は背臥位,立位,中腰位,重錘位の4肢位とし,背臥位,中腰位,重錘位は膝45°屈曲位とした.重錘位の重錘負荷量は,厚生労働省「職場における腰痛予防対策指針及び解説」に従い設定した.運動課題は,安静時と3秒間のPFM最大随意収縮(収縮時)とした.PFM筋力の指標として,安静時と収縮時の腟圧を腟圧計(MizCure,OWOMED社)を用い,右側の内腹斜筋(IO),外腹斜筋(EO),多裂筋(MF)の筋活動を表面筋電計(Tele Myo G2,Noraxon社)を用いて測定した.腟圧値と筋活動量は安静時と収縮時における最大値を各々2回測定し,平均値を採用した.被験筋の筋活動量は,安静時と収縮時の腟圧最大値における筋活動前後0.5秒の積分筋電値を徒手筋力検査法段階5での筋電値で正規化した(%IEMG).統計学的解析は,各肢位での安静時と収縮時の腟圧値と%IEMGについて,安静時・収縮時要因での比較,および肢位要因での比較を二元配置分散分析と多重比較法を用いて検討し,有意水準は5%とした.&lt;/p&gt;&lt;p&gt;【結果】&lt;/p&gt;&lt;p&gt; 腟圧値の比較では, 安静時・収縮時要因と肢位要因の間に交互作用を認めた.安静時・収縮時要因の比較では,各肢位で収縮時が安静時よりも高値を示し,肢位要因の比較では,収縮時,安静時ともに中腰位と重錘位が背臥位と立位よりも高値を示した.%IEMGの比較では,交互作用を認めず,安静時・収縮時要因と肢位要因の各々で有意差を認めた.肢位要因の比較では, IOの重錘位が立位よりも,中腰位が立位と背臥位よりも高値を示した.EOの重錘位が背臥位よりも,MFは重錘位,中腰位,立位,背臥位の順で高値を示した.また,安静時・収縮時要因の比較では,IOにおける安静時(背臥位6.5±6.2%,立位10.5±5.5%,中腰位23.0±16.4%,重錘位32.9±22.3%)と収縮時(背臥位36.6±56.2%,立位33.0±23.5%,中腰位56.2±45.0%,重錘位45.7±33.6%)の差が大きかった.&lt;/p&gt;&lt;p&gt;【結論】&lt;/p&gt;&lt;p&gt; 腟圧値の結果から,腹圧が上昇する中腰位,重錘位では,安静時及び収縮時ともに腟圧が高まることが明らかとなった. %IEMGは,全ての筋で各肢位の収縮時に高値を示した.なかでもIOはPFM収縮時の筋活動が高く,安静時との差が大きいことから,共同収縮筋として重要となる可能性が考えられる.以上より,腟圧は腹圧が上昇する中腰位, 重錘位で高まり,腟圧を高める共同収縮筋として体幹深層筋のIOが重要となる可能性が示唆された.なお,本研究はH28年度理学療法にかかわる研究助成を受けた(H28-B16).&lt;/p&gt;&lt;p&gt;【倫理的配慮，説明と同意】&lt;/p&gt;&lt;p&gt;本研究は,北海道千歳リハビリテーション大学倫理委員会の承認の下,実施した (承認番号2017-01).&lt;/p&gt;

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記述言語：日本語   出版者・発行元：日本女性骨盤底医学会  

骨盤臓器脱患者は、手術によって膀胱収縮力が一時的に悪化し、その後改善することを我々は報告してきた。しかしながら、膀胱収縮力を評価する方法に、validateされたものはまだ存在しない。そこで我々は、プレッシャーフロースタディにおけるパラメーターのWatts factorカーブのarea under the curveが、排尿全体の膀胱収縮能を示す可能性について検討を行った。(著者抄録)

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記述言語：日本語   出版者・発行元：(株)メディカ出版  

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記述言語：日本語   出版者・発行元：日本老年泌尿器科学会  

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記述言語：日本語   出版者・発行元：日本老年泌尿器科学会  

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記述言語：日本語   掲載種別：研究発表ペーパー・要旨（全国大会，その他学術会議）   出版者・発行元：(一社)日本排尿機能学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本排尿機能学会  

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記述言語：日本語   出版者・発行元：(一社)日本排尿機能学会  

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記述言語：日本語   出版者・発行元：(一社)日本排尿機能学会  

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記述言語：日本語   出版者・発行元：(一社)日本排尿機能学会  

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記述言語：日本語   出版者・発行元：(一社)日本排尿機能学会  

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記述言語：日本語   出版者・発行元：(一社)日本排尿機能学会  

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記述言語：日本語   出版者・発行元：日本小児泌尿器科学会  

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記述言語：日本語   出版者・発行元：医学図書出版(株)  

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記述言語：日本語   出版者・発行元：医学図書出版(株)  

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記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

認知症の原因には、本稿で取り上げるアルツハイマー病、レビー小体型認知症や血管性認知症がある。各タイプによって下部尿路症状(lower urinary tract symptoms;LUTS)の出現時期は異なっているが、多くの場合、切迫性尿失禁と機能性尿失禁の両方が出現する。近年の機能的脳画像の進歩によって、その病態は解明されてきている。その治療法は、安易な薬物治療は慎むべきであるが、切追性尿失禁であれば抗コリン薬やβ3受容体刺激薬の投与を検討し、機能性尿失禁に対しては排尿誘導や環境整備が中心となる。特に機能性尿失禁の対応には、個別に精神面に配慮することが大切である。認知症患者のLUTSに対する診断・治療は、看護介護スタッフの根気強い関わりが不可欠であり、医師の熱意とスタッフのレベル向上なくしては成し得ない。(著者抄録)

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記述言語：日本語   出版者・発行元：日本小児泌尿器科学会  

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記述言語：日本語   出版者・発行元：日本小児泌尿器科学会  

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器科学会総会事務局  

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器科学会総会事務局  

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器科学会総会事務局  

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器科学会総会事務局  

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器科学会総会事務局  

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記述言語：日本語   出版者・発行元：日本老年泌尿器科学会  

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記述言語：日本語   出版者・発行元：日本老年泌尿器科学会  

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記述言語：日本語   出版者・発行元：日本老年泌尿器科学会  

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記述言語：日本語   出版者・発行元：日本逆流性腎症フォーラム  

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記述言語：日本語   掲載種別：研究発表ペーパー・要旨（全国大会，その他学術会議）  

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本逆流性腎症フォーラム  

1991〜2016年に出生し、北海道大学で経過観察中の原発性の膀胱尿管逆流(VUR)346例を対象に、2006年以前に初診した173例(昔群)と2007年以降に初診した173例(今群)に分け、患者背景や関連検査、治療、経過の推移を調査した。初診時年齢は昔群10.4ヵ月、今群8.9ヵ月であった。その結果、女児の割合、尿路感染を契機にVURが診断される割合が増加したが、VUR gradeに変化はなかった。関連検査、処置の回数は減少していた。保存的に抗生剤の予防内服を行う症例が増加し、内服期間も延長したが、経過中の尿路感染の頻度に変化はなかった。根治術の適応基準はVURの残存ではなく、より尿路感染の有無を重視するよう変化していた。VUR自体は時間経過と共に自然消失例が増加し、高度VUR例が減少した。経過中の腎瘢痕進行の頻度に変化はなかった。現在、VURの消失ではなく、排尿や腎機能に焦点を当てた診察を行い、保存的治療で問題なく経過している。

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記述言語：日本語   出版者・発行元：日本女性骨盤底医学会  

泌尿器科において、ウロダイナミクス検査は、排尿状態を確認するためにはなくてはならない検査である。今回は、当科における女性高齢者に対するウロダイナミクス検査の現状を確認するために過去5年間のウロダイナミクス検査を検討した。65歳以上の249例に対して、ウロダイナミクス検査を施行しており、うち女性は99例であった。検査内容は、膀胱内圧測定が7例、内圧流量測定が72例、透視下のビデオウロダイナミクスが20例であった。対象疾患は、骨盤臓器脱、尿失禁、神経因性膀胱、腎移植前評価であった。なかでも、神経因性膀胱患者10例は、検査によって2例が自己導尿を開始及び中止という排尿管理方法の変更が決定されており、本検査が排尿管理法を決定した重要な検査であることが再認識された。また、検査に伴う合併症は、1人も見られなかった。高齢者においてもウロダイナミクス検査は、有効かつ安全に施行されていた。(著者抄録)

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記述言語：日本語   出版者・発行元：(株)メディカ出版  

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記述言語：日本語   出版者・発行元：(一社)日本泌尿器内視鏡学会  

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記述言語：日本語   出版者・発行元：(株)東京医学社  

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記述言語：日本語   出版者・発行元：(一社)日本排尿機能学会  

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記述言語：日本語   出版者・発行元：(一社)日本排尿機能学会  

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記述言語：日本語   出版者・発行元：(一社)日本排尿機能学会  

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記述言語：日本語   出版者・発行元：(一社)日本排尿機能学会  

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記述言語：日本語   出版者・発行元：(一社)日本排尿機能学会  

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記述言語：日本語   出版者・発行元：(有)科学評論社  

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記述言語：日本語   出版者・発行元：(一社)日本生殖医学会  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：WILEY  

Web of Science

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：WILEY  

Web of Science

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：WILEY  

Web of Science

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記述言語：日本語   出版者・発行元：医学図書出版(株)  

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記述言語：日本語   出版者・発行元：医学図書出版(株)  

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記述言語：日本語   出版者・発行元：医学図書出版(株)  

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記述言語：日本語   出版者・発行元：日本小児泌尿器科学会  

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記述言語：日本語   出版者・発行元：日本小児泌尿器科学会  

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記述言語：日本語   出版者・発行元：日本小児泌尿器科学会  

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