Valentini Françoise A, Zimmern Philippe E, Besson Gilbert R, Nelson Pierre P
Université Pierre et Marie Curie, Paris, France.
Neurourol Urodyn. 2003;22(1):45-53. doi: 10.1002/nau.10069.
To gain insight from an adaptable computer model of micturition into the pathophysiological phenomena occurring during voiding in men with lower urinary tract symptoms due to benign prostatic enlargement (BPE).
By using the Valentini-Besson-Nelson (VBN) micturition model, we proceeded with an in-depth and systematic analysis of the pressure-flow studies of 71 patients (119 tracings) provided by three different institutions.
The modelized analysis identified and quantified several pathophysiological phenomena during voiding: compressive obstruction, variations in detrusor contraction force (enhanced or reduced), progressive relaxation of the prostatic fossa, occasional detrusor-bladder neck coupling, and sphincteric control dysfunctions. Once these phenomena were taken into account by using a set of new parameters, the computed flow rate and detrusor pressure curves became very similar to the recorded ones.
The accuracy of this sophisticated analysis allows us to separate and to study during each voiding the phenomena belonging to the urethra, the detrusor, the bladder neck, the prostate, and their neurologic coordination in BPE patients.
通过一个适应性排尿计算机模型，深入了解良性前列腺增生（BPE）所致下尿路症状男性排尿过程中发生的病理生理现象。
使用瓦伦蒂尼-贝松-尼尔森（VBN）排尿模型，我们对三个不同机构提供的71例患者（119条记录）的压力-流率研究进行了深入系统的分析。
模型化分析确定并量化了排尿过程中的几种病理生理现象：压迫性梗阻、逼尿肌收缩力变化（增强或减弱）、前列腺窝逐渐松弛、偶尔的逼尿肌-膀胱颈耦合以及括约肌控制功能障碍。一旦通过一组新参数考虑这些现象，计算出的流率和逼尿肌压力曲线与记录的曲线非常相似。
这种精细分析的准确性使我们能够在每次排尿过程中分离并研究BPE患者中属于尿道、逼尿肌、膀胱颈、前列腺及其神经协调的现象。
