Cucchi Antonio, Quaglini Silvana, Rovereto Bruno
Divisione di Urologia, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico S. Matteo and Dipartimento di Informatica e Sistemistica, Università di Pavia, Pavia, Italy.
J Urol. 2007 Aug;178(2):563-7; discussion 567. doi: 10.1016/j.juro.2007.03.122. Epub 2007 Jun 14.
In men with urinary incontinence from idiopathic detrusor overactivity we determined whether bladder voiding dynamics differs between those with and without urgent micturition.
We retrospectively assessed urodynamic findings in 3 groups of 22 men each. Groups 1 and 2 had idiopathic detrusor overactivity with detrusor overactivity incontinence and with micturition urgency in group 1. Group 2 showed no urgency but felt a strong voiding desire just after the onset of involuntary micturition. Control group 3 included nonneurological unobstructed men undergoing urodynamic examination for mixed reasons who proved to be urodynamically normal. Patients with detrusor overactivity and controls were assessed by nonparametric statistics for significant differences in bladder voiding dynamics.
Detrusor contraction strength proved to be increased in groups 1 and 2 with the highest levels in group 1. Detrusor contraction velocity had the highest levels in group 1 and it differed insignificantly in groups 2 and 3. Voiding contractions were equally well sustained in groups 1 and 3, and proved to be less well sustained in group 2.
Detrusor overactivity involves enhanced detrusor contraction strength levels, particularly in patients who feel urgency. In urgency-free patients with detrusor overactivity detrusor contraction velocity differs insignificantly from that in controls and voiding detrusor contractions proved to be less well sustained than in controls and patients who experienced urgency. This suggests that detrusor contraction velocity may have a role in causing urgency and urgency may have a role in enhancing and sustaining involuntary voiding detrusor contractions in patients with detrusor overactivity.
在患有特发性逼尿肌过度活动导致尿失禁的男性中，我们确定了有急迫性排尿和无急迫性排尿的患者之间膀胱排尿动力学是否存在差异。
我们回顾性评估了3组男性的尿动力学检查结果，每组22人。第1组和第2组患有特发性逼尿肌过度活动，第1组伴有逼尿肌过度活动失禁和排尿急迫感。第2组无急迫感，但在不自主排尿开始后立即有强烈的排尿欲望。对照组3包括因各种原因接受尿动力学检查的非神经源性无梗阻男性，检查结果显示其尿动力学正常。对逼尿肌过度活动患者和对照组进行非参数统计，以评估膀胱排尿动力学的显著差异。
第1组和第2组的逼尿肌收缩强度增加，第1组最高。第1组的逼尿肌收缩速度最高，第2组和第3组差异不显著。第1组和第3组的排尿收缩维持情况相同，第2组则较差。
逼尿肌过度活动涉及逼尿肌收缩强度增强，尤其是在有急迫感的患者中。在无急迫感的逼尿肌过度活动患者中，逼尿肌收缩速度与对照组相比差异不显著，且排尿逼尿肌收缩的维持情况比对照组和有急迫感的患者差。这表明逼尿肌收缩速度可能在导致急迫感方面起作用，而急迫感可能在增强和维持逼尿肌过度活动患者的不自主排尿逼尿肌收缩方面起作用。
