Sekido Noritoshi, Hinotsu Shiro, Kawai Koji, Shimazui Toru, Akaza Hideyuki
Department of Urology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Int J Urol. 2006 Oct;13(10):1276-9. doi: 10.1111/j.1442-2042.2006.01558.x.
We retrospectively evaluated the incidence of detrusor overactivity (DO) in uncomplicated overactive bladder syndrome (OAB) patients.
From December 1993 to October 2003, 139 adult patients were referred to an urodynamic clinic for urodynamic evaluation of frequency and/or urinary incontinence. Of these, 50 patients (12 males and 38 females) with urgency, without any overt pathological conditions, were retrospectively evaluated in regard to patient age, storage symptoms, urodynamic parameters, and the presence or absence of DO (DO patients or no DO patients, respectively).
The overall incidence of DO was 75% (nine of 12 patients) and 36.8% (14 of 38 patients) in male and female patients, respectively. Two of nine male DO patients and five of 14 female DO patients revealed DO after provocative maneuvers. In male patients, all DO patients were OAB wet. In female patients, 13 of 14 DO patients were OAB wet (92.9%), whereas 17 of 24 no DO patients were also OAB wet (70.8%). Compared with no DO patients, female DO patients revealed statistically significant lower maximum cystometric capacity (P = 0.0139) and lower vesical compliance (P = 0.0002). Although aged 60 years or more was associated with DO in univariate analysis in female patients, any symptoms, even incontinence, were not associated with DO in both sexes.
It is supposed that, in contrast to male OAB, DO might not be a major underlying cause of uncomplicated female OAB.
我们回顾性评估了单纯性膀胱过度活动症（OAB）患者逼尿肌过度活动（DO）的发生率。
从1993年12月至2003年10月，139例成年患者因尿频和/或尿失禁被转诊至尿动力学诊所进行尿动力学评估。其中，50例（12例男性和38例女性）有尿急且无任何明显病理状况的患者，就患者年龄、储尿期症状、尿动力学参数以及是否存在DO（分别为DO患者或非DO患者）进行了回顾性评估。
男性和女性患者中DO的总体发生率分别为75%（12例患者中的9例）和36.8%（38例患者中的14例）。9例男性DO患者中有2例和14例女性DO患者中有5例在激发试验后出现DO。在男性患者中，所有DO患者均为OAB伴尿失禁。在女性患者中，14例DO患者中有13例为OAB伴尿失禁（92.9%），而24例非DO患者中有17例也为OAB伴尿失禁（70.8%）。与非DO患者相比，女性DO患者的最大膀胱测压容量显著更低（P = 0.0139），膀胱顺应性也更低（P = 0.0002）。尽管在女性患者的单因素分析中，60岁及以上与DO相关，但在两性中，任何症状，甚至尿失禁，均与DO无关。
据推测，与男性OAB不同，DO可能不是单纯性女性OAB的主要潜在病因。
