Digesu G Alessandro, Basra Ramandeep, Khullar Vik, Hendricken Caroline, Camarata Michelle, Kelleher Con
Department of Urogynaecology, Imperial College, Cambridge Wing, St Mary's Hospital, London, United Kingdom.
Neurourol Urodyn. 2009;28(3):191-6. doi: 10.1002/nau.20627.
To determine the position and character of bladder filling sensations in women undergoing urodynamic investigations.
Women with lower urinary tract symptoms referred to urodynamic clinics of two tertiary referral teaching hospitals were prospectively studied. During filling cystometry the women were asked to describe the bladder sensations at the first sensation of bladder filling, first desire to void, strong desire to void, maximum bladder capacity and if the woman felt urgency. Women were also asked to define the time that the voiding could be delayed and to indicate the position of each sensation on a body map. Women were classified into four groups according to urodynamic diagnosis: detrusor overactivity (DO), urodynamic stress incontinence (USI), co-existing DO and USI (mixed) and inconclusive urodynamics; the latter was excluded from the study. Bladder sensations were compared between these groups using Chi squared and Kruskall-Wallis tests.
Eighty-two women were studied. Women with DO and mixed urodynamic diagnosis predominantly described the bladder sensations as being perineal or vaginal in origin, whereas those with USI felt the sensations suprapubically. The character of bladder sensation was not significantly different between the diagnostic groups and the intensity increased with larger bladder volume. The duration that women could delay voiding was significantly different between different urodynamic groups.
Bladder sensations experienced during cystometry are different in position and duration in relation to urodynamic diagnoses. This indicates that uniform descriptions of sensations during filling cystometry might not be appropriate to different urodynamic diagnoses.
确定接受尿动力学检查的女性膀胱充盈感觉的位置和特征。
对两家三级转诊教学医院尿动力学门诊收治的下尿路症状女性患者进行前瞻性研究。在膀胱测压过程中，要求这些女性描述膀胱充盈初始感觉、首次排尿欲望、强烈排尿欲望、最大膀胱容量时的膀胱感觉，以及是否有尿急感。还要求女性确定可以延迟排尿的时间，并在人体图上指出每种感觉的位置。根据尿动力学诊断将女性分为四组：逼尿肌过度活动（DO）、尿动力学压力性尿失禁（USI）、DO和USI并存（混合型）以及尿动力学检查结果不明确；后者被排除在研究之外。使用卡方检验和克鲁斯卡尔 - 沃利斯检验对这些组之间的膀胱感觉进行比较。
共研究了82名女性。DO和混合型尿动力学诊断的女性主要将膀胱感觉描述为起源于会阴或阴道，而USI的女性则感觉是耻骨上的。不同诊断组之间膀胱感觉的特征没有显著差异，且随着膀胱容量增大感觉强度增加。不同尿动力学组女性能够延迟排尿的时间有显著差异。
膀胱测压期间体验到的膀胱感觉在位置和持续时间上与尿动力学诊断有关。这表明在膀胱充盈测压期间对感觉进行统一描述可能不适用于不同的尿动力学诊断。
