Groutz A, Blaivas J G, Sassone A M
Weill Medical College, Cornell University, New York, New York, USA.
J Urol. 2000 Jul;164(1):109-14.
We evaluated whether a 7Fr transurethral catheter affects urinary flow in women undergoing pressure flow studies for voiding symptoms.
We reviewed a urodynamic database of 600 consecutive women referred for the evaluation of voiding symptoms. Before urodynamics all patients voided privately using a standard toilet and free flow was recorded. Urodynamics were performed using a 7Fr double lumen transurethral catheter. At functional bladder capacity patients were asked to void in the sitting position and pressure flow studies were performed. All uroflowmetry tracings were inspected and analyzed manually. Only patients who voided similar volumes varying by less than 20% on the free and pressure flow studies were assessed. Free and pressure flow parameters were compared according to voided volume category, main urodynamic diagnosis, uroflowmetry pattern and pre-void bladder volume.
A similar volume was voided on the free and pressure flow studies of 100 women. In each voided volume category and urodynamic diagnosis pressure flow parameters were significantly different from the equivalent free flow parameters in all but 4 cases. Specifically the maximum flow rate was significantly less and flow time was significantly longer on pressure versus free flow studies (each p <0.01). An intermittent flow pattern was more common on pressure than in free flow measurements (43% versus 9%).
A 7Fr transurethral catheter may adversely affect uroflowmetry parameters in women undergoing pressure flow studies for lower urinary tract symptoms. This finding may have further clinical implications regarding the interpretation of these parameters as well as establishment of an accurate diagnosis.
我们评估了一根7F经尿道导管对因排尿症状接受压力流研究的女性的尿流是否有影响。
我们回顾了一个包含600例因排尿症状转诊接受评估的连续女性的尿动力学数据库。在进行尿动力学检查之前，所有患者均在标准马桶上自行排尿，并记录自由尿流情况。使用一根7F双腔经尿道导管进行尿动力学检查。当膀胱达到功能性容量时，要求患者坐在座位上排尿，并进行压力流研究。所有尿流率曲线均由人工检查和分析。仅评估在自由尿流和压力流研究中排尿量相似、差异小于20%的患者。根据排尿量类别、主要尿动力学诊断、尿流率模式和排尿前膀胱容量比较自由尿流和压力流参数。
100名女性的自由尿流和压力流研究中排尿量相似。在每个排尿量类别和尿动力学诊断中，除4例病例外，压力流参数与相应的自由尿流参数均有显著差异。具体而言，与自由尿流研究相比，压力流研究中的最大尿流率显著降低，尿流时间显著延长（均p<0.01）。压力流测量中出现间歇性尿流模式比自由尿流测量中更常见（43%对9%）。
对于因下尿路症状接受压力流研究的女性，一根7F经尿道导管可能会对尿流率参数产生不利影响。这一发现可能对这些参数的解读以及准确诊断的建立具有进一步的临床意义。
