Haylen Bernard T, Krishnan Surya, Schulz Serena, Verity Louise, Law Matthew, Zhou Jialun, Sutherst John
St Vincent's Clinic, Suite 904, 438 Victoria Street, Darlinghurst, N.S.W., 2010, Australia.
Int Urogynecol J Pelvic Floor Dysfunct. 2007 Jan;18(1):53-6. doi: 10.1007/s00192-006-0094-x. Epub 2006 Apr 5.
Voiding difficulty has been relatively overlooked as a diagnosis. Previous estimates of its prevalence have generally been no more than 14% with one exception at 24%. The aim of this study is to determine the true prevalence and associations of voiding difficulty using a validated definition [urine flow rate under 10th centile of the Liverpool Nomograms and/or residual urine volume (by transvaginal ultrasound) more than 30 ml]. This study involved 592 women referred for an initial urogynecological assessment including urodynamics. Data were separated according to the presence or absence of voiding difficulty. The prevalence of voiding difficulty was 39%, far higher than previous estimates. It is the third most common urodynamic diagnosis behind urodynamic stress incontinence (USI-72%) and uterine/vaginal prolapse (61%) and ahead of the overactive bladder (13%). Voiding difficulty significantly increased in prevalence with age and increasing grades of all types of uterine/vaginal prolapse. Prolapse appeared to be the main factor in the age deterioration. Other significant positive relationships with voiding difficulty were prior hysterectomy and prior continence surgery, whilst USI and the symptom and sign of stress incontinence had significant inverse relationships.
排尿困难作为一种诊断相对被忽视。以往对其患病率的估计一般不超过14%，仅有一次例外为24%。本研究的目的是使用经过验证的定义[尿流率低于利物浦列线图第10百分位数和/或残余尿量（经阴道超声检查）超过30毫升]来确定排尿困难的真实患病率及其相关因素。本研究纳入了592名因初次泌尿妇科评估（包括尿动力学检查）而转诊的女性。数据根据是否存在排尿困难进行分类。排尿困难的患病率为39%，远高于以往估计。它是第三常见的尿动力学诊断，仅次于尿动力学压力性尿失禁（USI - 72%）和子宫/阴道脱垂（61%），排在膀胱过度活动症（13%）之前。排尿困难的患病率随年龄增长以及各种类型子宫/阴道脱垂程度的增加而显著上升。脱垂似乎是年龄增长导致排尿困难的主要因素。与排尿困难其他显著的正相关关系包括既往子宫切除术和既往控尿手术，而USI以及压力性尿失禁的症状和体征则与之存在显著的负相关关系。
