Department of Urology, University of Michigan, Ann Arbor, Michigan, USA.
Neurourol Urodyn. 2009;28(8):944-8. doi: 10.1002/nau.20729.
Obstructive symptoms such as slow stream, dribbling and straining are often reported by painful bladder syndrome and interstitial cystitis (PBS/IC) patients. Our hypothesis was that some patients with PBS/IC have an associated measurable bladder outlet obstruction (BOO) secondary to dysfunctional voiding and that those patients with more severe PBS/IC are more likely to have BOO.
This is a retrospective chart review of female patients diagnosed with PBS/IC based on the NIDDK research definition. Charts were reviewed for clinical symptom severity, ulcer or non-ulcer PBS/IC on cystoscopy, and pressure-flow urodynamics (UDPF). Patients were excluded if they had a urinary infection at the time of urodynamics or did not meet study entry requirements. The cut-off values of <or=12 ml/sec and >or=25 cm of water was used to define BOO.
Of the 231 women: 38 had ulcer PBS/IC and 193 had non-ulcer PBS/IC. MCC was 269 ml in non-ulcer PBS/IC and 200 ml in ulcer PBS/IC (P = 0.006). One hundred eleven women (48%) met criteria for obstruction. MCC was 298 ml in the non-obstructed group and 214 ml in the obstructed group (P < 0.0001). The maximum flow with non-ulcer PBS/IC was 11.0 ml/sec and in ulcer PBS/IC 8.9 ml/sec (P = 0.04) Detrusor pressure at maximum flow was 33.3 cm H(2)O, in non-ulcer, and 37.4 cm H(2)O in ulcer PBS/IC (P = 0.01).
Forty-eight percent of our PBS/IC patients have BOO, and increasing severity of PBS/IC is associated with higher voiding pressure.
疼痛性膀胱综合征和间质性膀胱炎（PBS/IC）患者常报告有阻塞症状，如尿流缓慢、滴沥和费力。我们的假设是，一些 PBS/IC 患者存在与功能性排尿障碍相关的可测量的膀胱出口梗阻（BOO），并且那些 PBS/IC 症状更严重的患者更有可能出现 BOO。
这是一项基于 NIDDK 研究定义诊断为 PBS/IC 的女性患者的回顾性图表审查。对图表进行了临床症状严重程度、膀胱镜检查时的溃疡或非溃疡 PBS/IC 以及压力-流尿动力学（UDPF）的审查。如果患者在尿动力学检查时患有尿路感染或不符合研究纳入标准，则将其排除在外。使用<或=12 ml/sec 和>或=25 cm 的水来定义 BOO。
在 231 名女性中：38 名患有溃疡 PBS/IC，193 名患有非溃疡 PBS/IC。非溃疡 PBS/IC 的 MCC 为 269 ml，溃疡 PBS/IC 的 MCC 为 200 ml（P = 0.006）。111 名女性（48%）符合梗阻标准。非梗阻组的 MCC 为 298 ml，梗阻组为 214 ml（P < 0.0001）。非溃疡 PBS/IC 的最大流量为 11.0 ml/sec，溃疡 PBS/IC 为 8.9 ml/sec（P = 0.04）。非溃疡时的最大流道逼尿肌压力为 33.3 cm H₂O，溃疡时为 37.4 cm H₂O（P = 0.01）。
我们的 PBS/IC 患者中有 48%存在 BOO，并且 PBS/IC 的严重程度增加与更高的排尿压力相关。
