Ku Ja Hyeon, Um Jin Mo, Shin Jae Wook, Yang Ji Hyeon, Paick Jae-Seung
Department of Urology, Seoul Veterans Hospital, Seoul, Korea.
Urology. 2006 May;67(5):978-83. doi: 10.1016/j.urology.2005.11.050.
To determine the significance of nocturnal hesitancy in the treatment of men with lower urinary tract symptoms.
A total of 123 patients with nocturia were prospectively studied. The nocturnal hesitancy scores ranged from 0 to 5 and were scored according to the International Prostate Symptom Score. The patients were stratified on the basis of their nocturnal hesitancy scores as group 1 (0 to 1, n = 57), group 2 (2 to 3, n = 45), and group 3 (4 to 5, n = 21). All patients received treatment with an alpha-blocker once daily for 4 weeks.
Group 3 scored significantly higher on the International Prostate Symptom Score at baseline and after treatment than did group 1. The actual number of nightly voids was greatest in group 3 and was lowest in group 1 (P = 0.011 at baseline and P = 0.046 after treatment, respectively). The baseline nocturia indexes were greatest in group 3 and were lowest in group 2 (P = 0.027). A significant but weak correlation was also noted between the nocturia hesitancy score and the differences in scores between the posttreatment and baseline voiding symptoms (r = -0.234, P = 0.021) and total International Prostate Symptom Score (r = -0.270, P = 0.011), respectively. In our multivariate analyses, the straining score was a significant determinant of nocturnal hesitancy.
The results of our study revealed that more emphasis should be placed on nocturnal hesitancy in the terminology of lower urinary tract symptoms. Additional research regarding the pathophysiologic mechanisms underlying nocturnal hesitancy, as well as its effects on those with it, is clearly warranted.
确定夜尿踌躇在男性下尿路症状治疗中的意义。
对123例夜尿症患者进行前瞻性研究。夜尿踌躇评分范围为0至5分，根据国际前列腺症状评分进行评分。患者根据夜尿踌躇评分分层为第1组（0至1分，n = 57）、第2组（2至3分，n = 45）和第3组（4至5分，n = 21）。所有患者每日接受一次α受体阻滞剂治疗，持续4周。
第3组在基线和治疗后的国际前列腺症状评分显著高于第1组。每晚实际排尿次数在第3组最多，在第1组最少（基线时P = 0.011，治疗后P = 0.046）。夜尿症指数在第3组最高，在第2组最低（P = 0.027）。夜尿踌躇评分与治疗后和基线排尿症状评分差异（r = -0.234，P = 0.021）以及国际前列腺症状总分（r = -0.270，P = 0.011）之间也存在显著但较弱的相关性。在我们的多变量分析中，用力排尿评分是夜尿踌躇的一个重要决定因素。
我们的研究结果表明，在下尿路症状术语中应更加强调夜尿踌躇。显然有必要对夜尿踌躇潜在的病理生理机制及其影响进行更多研究。
