Hansen F, Olsen L, Atan A, Nordling J
Department of Urology, Herlev Hospital, University of Copenhagen, Denmark.
Neurourol Urodyn. 1999;18(3):205-14. doi: 10.1002/(sici)1520-6777(1999)18:3<205::aid-nau7>3.0.co;2-8.
The within and between examination variation in selected test parameters and test results in repeated pressure-flow studies was determined in a prospective study of consecutive pressure-flow examinations in 22 patients. The patients were pressure-flow tested twice within a month. Furthermore, it was evaluated whether there was a systematic change in the measured parameters during retesting. By using the Abrams-Griffiths nomogram, patients were classified as obstructed, equivocal, or unobstructed. Within and between examination variations in classification were evaluated. We found a systematic variation in P(det.Qmax) during testing, which in the absence of statistically significant systematic variations in P(det.Close) and Qmax, indicates a physiological effect of repeated pressure-flow studies, resulting in a less-obstructed second voiding. Supporting this, we found that all patients who changed group of classification of bladder outlet obstruction in the first examination shifted to a group of less obstruction, as did 66% of the patients who changed group of classification of bladder outlet obstruction in the second examination. Still, 80, respectively 85%, of the patients remained in the same group of classification of bladder outlet obstruction during retesting in the first and second examinations, respectively. Classifying the degree of bladder outlet obstruction by Qmax, P(det.Qmax), and P(det.Close) 85% of the patients reproduced their test results accurately in both examinations and taking only the first voiding in both examinations into account 95% reproduced their test results.
在一项对22例患者进行连续压力-流率检查的前瞻性研究中,确定了重复压力-流率研究中选定测试参数和测试结果的检查内及检查间差异。患者在一个月内接受了两次压力-流率测试。此外,还评估了复测期间测量参数是否存在系统性变化。通过使用艾布拉姆斯-格里菲思列线图,将患者分为梗阻性、可疑性或无梗阻性。评估了分类的检查内及检查间差异。我们发现在测试过程中P(det.Qmax)存在系统性变化,而在P(det.Close)和Qmax无统计学显著系统性变化的情况下,这表明重复压力-流率研究具有生理效应,导致第二次排尿梗阻程度减轻。支持这一点的是,我们发现所有在第一次检查中改变膀胱出口梗阻分类组的患者都转移到了梗阻程度较轻的组,第二次检查中改变膀胱出口梗阻分类组的患者中有66%也是如此。尽管如此,在第一次和第二次检查的复测过程中,分别有80%和85%的患者仍处于相同的膀胱出口梗阻分类组。通过Qmax、P(det.Qmax)和P(det.Close)对膀胱出口梗阻程度进行分类,85%的患者在两次检查中都准确地再现了他们的测试结果,仅考虑两次检查中的第一次排尿时,95%的患者再现了他们的测试结果。