Fang Qiang, Song Bo, Li Weibing, Lu Gensheng, Jin Xiyu, Zhang Xuwei, Fan Ruhui
Center of Urology of PLA, Southwest Hospital, The Third Military Medical University, Chongqing, China.
Neurourol Urodyn. 2007;26(6):842-6. doi: 10.1002/nau.20227.
To study the role of UPP in assessing bladder outlet obstruction (BOO) due to benign prostatic enlargement (BPE).
Urodynamic results from 1281 elderly men with Lower urinary tract symptoms (LUTS) obtained from September 1999 through July 2005 were retrospectively analyzed. Independent sample t-test or Wilcoxon signed-rank test was used to compare the parameters of different groups according to PFS. Chi-square test was used to compare the percentage of urethral pressure profile (UPP) types between different groups. ROC curve was used to study the practical value of UPP parameters in diagnosing BOO.
According to PFS, patients were divided into three groups: Obstructed, equivocal obstructed and unobstructed. There was significant difference between the unobstructed and obstructed group in the age of patients, bladder capacity, residual volume, voided volume, voided time, prostatic plateau area (PPA), prostatic length, functional profile length, pressure of bladder neck, and pressure of seminal colliculus, but not in maximum urethral closure pressure. All UPP parameters correlated significantly to the diagnosis of bladder outlet obstruction due to BPE. The largest area under the ROC curve was that of PPA.
Our results indicate that PPA on UPP is useful in assessing the grade of obstruction due to BPE when PFS fails, a finding still to be evaluated by prospective studies.
研究尿道压力分布图(UPP)在评估良性前列腺增生(BPE)所致膀胱出口梗阻(BOO)中的作用。
回顾性分析1999年9月至2005年7月期间1281例有下尿路症状(LUTS)的老年男性患者的尿动力学结果。根据前列腺症状评分(PFS),采用独立样本t检验或Wilcoxon符号秩检验比较不同组的参数。采用卡方检验比较不同组之间尿道压力分布图(UPP)类型的百分比。采用ROC曲线研究UPP参数在诊断BOO中的实用价值。
根据PFS,患者分为三组:梗阻组、可疑梗阻组和非梗阻组。非梗阻组与梗阻组在患者年龄、膀胱容量、残余尿量、排尿量、排尿时间、前列腺平台面积(PPA)、前列腺长度、功能曲线长度、膀胱颈压力和精阜压力方面存在显著差异,但在最大尿道闭合压力方面无显著差异。所有UPP参数与BPE所致膀胱出口梗阻的诊断均显著相关。ROC曲线下面积最大的是PPA。
我们的数据表明,当PFS无法评估时,UPP上的PPA有助于评估BPE所致梗阻的程度,这一发现仍有待前瞻性研究进行评估。