Clinical study of urethral pressure profile (author's transl)

Abstract

Pre-and post-operative urethral pressure profile in various lower uropathies, obtained by Brown's method was analyzed for urethral length and pressure in the external sphincteric area.1) The posterior urethral length in normal male was 3.6cm (2.0-4.5cm) on the average, and pressure in the external sphincteric area was 30mmHg (20-42mmHg).2) The average posterior urethra was lengthened to 4.3cm (3.0-7.0cm) and the average pressure at the external sphincteric area increased to 39mmHg (20-50mmHg) in 16 cases of benign prostatic hypertrophy and 3 cases of prostatic carcinoma. There was a marked reduction in both length and pressure in postoperative profile.3) In vesical neck contracture, preoperative urethral length was 4.0cm (3.0-4.5cm) and pressure was 35mmHg (28-50mmHg). The postoperative reduction in length and pressure was less marked comparing to the prostatic hypertrophy group.4) In chronic paraplegic patients the length was 1.8cm (1.3-2.5cm) and the pressure was 23.9 (10-36mmHg). The profile was independent of the level of cord lesion and the duration after injury. No difference in profile was observed between the groups with or without subarachnoidal phenol block. The wave and the spike in anterior urethral profile, which were scarecely found in nonparaplegics, were frequently observed.5) The urethral pressure profile offered valuable clues to the identification of the position and the size of anterior urethral diverticulum and urethral stricture, which helped the diagnosis, selection of operative approach and evaluation of postoperative result.6) Pressure at the external sphincteric area of patients with post-prostatectomy incontinence is lower than 10mmHg. No patient with pressure above 14mmHg at this area was incontinent.This is on easily performable method even in the outpatient clinic, and yet the careful analysis of the curvature gives valuable informations as to the management of various lower uropathies.