Oelke Matthias, Baard Joyce, Wijkstra Hessel, de la Rosette Jean J, Jonas Udo, Höfner Klaus
Academic Medical Center of Amsterdam, The Netherlands; Medical School of Hannover, Germany.
Eur Urol. 2008 Aug;54(2):419-26. doi: 10.1016/j.eururo.2008.02.017. Epub 2008 Feb 25.
Detrusor overactivity is one known cause of lower urinary tract symptoms and has been linked to bladder storage symptoms (urgency, frequency, or urge incontinence).
To determine clinical and urodynamic parameters associated with detrusor overactivity in patients with suspected benign prostatic hyperplasia.
DESIGN, SETTING, AND PARTICIPANTS: During 1993-2003, urodynamic investigations were performed in patients aged 40 yr or older and with lower urinary tract symptoms, benign prostatic enlargement, and/or suspicion of bladder outlet obstruction (maximum flow rate < 15 ml/s or postvoid residual urine > 50 ml).
Detrusor overactivity was defined according to the new International Continence Society classification (2002) as involuntary detrusor contractions during cystometry, which may be spontaneous or provoked, regardless of amplitude. The Schäfer algorithm was used to determine bladder outlet obstruction.
In total, 1418 men were investigated (median age: 63 yr) of whom 864 men (60.9%) had detrusor overactivity. In univariate analysis, men with detrusor overactivity were significantly older, more obstructed, had larger prostates, higher irritative International Prostate Symptoms Score subscores, a lower voiding volume at free uroflowmetry, and a lower bladder capacity at cystometry. The prevalence of detrusor overactivity rose continuously with increasing bladder outlet obstruction grade. Multivariate analysis showed that only age and bladder outlet obstruction grade were independently associated with detrusor overactivity. After age adjustment, the odds ratios of detrusor overactivity compared to Schäfer class 0 were 1.2 for class I, 1.4 for class II, 1.9 for class III, 2.5 for class IV, 3.4 for class V, and 4.7 for class VI.
In patients with clinical benign prostatic hyperplasia, detrusor overactivity is independently associated with age and bladder outlet obstruction. The probability of detrusor overactivity rises with increasing age and bladder outlet obstruction grade.
逼尿肌过度活动是下尿路症状的一个已知病因，并且与膀胱储尿症状（尿急、尿频或急迫性尿失禁）相关。
确定疑似良性前列腺增生患者中与逼尿肌过度活动相关的临床和尿动力学参数。
设计、场所和参与者：在1993年至2003年期间，对年龄40岁及以上、有下尿路症状、良性前列腺增大和/或疑似膀胱出口梗阻（最大尿流率<15 ml/s或排尿后残余尿量>50 ml）的患者进行了尿动力学检查。
根据新的国际尿控协会分类（2002年），逼尿肌过度活动定义为膀胱测压期间的非自愿逼尿肌收缩，其可以是自发的或诱发的，与幅度无关。采用施费尔算法确定膀胱出口梗阻。
总共对1418名男性进行了研究（中位年龄：63岁），其中864名男性（60.9%）有逼尿肌过度活动。在单因素分析中，有逼尿肌过度活动的男性年龄显著更大、梗阻更严重、前列腺更大、刺激性国际前列腺症状评分子分数更高、自由尿流率时的排尿量更低以及膀胱测压时的膀胱容量更低。逼尿肌过度活动的患病率随着膀胱出口梗阻等级的增加而持续上升。多因素分析表明，只有年龄和膀胱出口梗阻等级与逼尿肌过度活动独立相关。年龄调整后，与施费尔0级相比，逼尿肌过度活动的比值比在I级为1.2，II级为1.4，III级为1.9，IV级为2.5，V级为3.4，VI级为4.7。
在临床诊断为良性前列腺增生的患者中，逼尿肌过度活动与年龄和膀胱出口梗阻独立相关。逼尿肌过度活动的可能性随着年龄和膀胱出口梗阻等级的增加而升高。
