Blaivas Jerry G, Panagopoulos Georgia, Weiss Jeffrey P, Somaroo Chandra
Weill Cornell Medical College, New York, New York 10021, USA.
Neurourol Urodyn. 2009;28(3):188-90. doi: 10.1002/nau.20525.
To determine whether urinary urgency, as defined by the International Continence Society, is an intensification of the normal sensation that occurs when micturition must be delayed once the urge to void is felt (Type 1 urgency) or a discrete, pathologic symptom different from the normal urge (Type 2 urgency).
Forty-eight consecutive patients who complained of urinary urgency completed two different questionnaires designed to answer the question posed above. The patients were divided into two groups of 24. For the test-retest, group 1 completed questionnaire 1 twice within 3-10 days and group 2 did the same with questionnaire 2. On the second administration of the questionnaire, each subject crossed over and answered the other questionnaire. For the test-retest, since the data set is dichotomous (yes/no), the degree of agreement between the two sets of data was assessed by calculating the kappa coefficient.
There were 37 women and 11 men ranging in age from 54 to 87 years. There was no difference in age and sex between the two groups (P = 0.19). There was excellent agreement in the test-retest responses for both questionnaires (kappa = 1.0, P < 0.001). For questionnaire 1, the urge sensation was an intensification of the normal sensation in 33 (68.8%) and it was a different sensation in 15 (31.3%). Similarly, for questionnaire 2, it was an intensification of the normal urge in 34 (70.8%) and different in 14 (29.2%). The differences in patient responses between the two groups were not significant. In the crossover section, only 1 of 48 subjects changed their response, resulting in a very high degree of agreement (kappa = .95, p < .001). Combining the two groups, urgency was perceived as an intensification of the normal urge to void in 33/48 patients (69%), a different sensation in 14/48 (29%) and 1/48 (2%) was not sure.
Urgency is comprised of at least two different sensations. One is an intensification of the normal urge to void and the other is a different sensation. The implications of this distinction are important insofar as they may have different etiologies and respond differently to treatment.
确定国际尿控协会所定义的尿急，是排尿冲动出现后必须延迟排尿时正常感觉的强化（1型尿急），还是一种与正常冲动不同的独立病理性症状（2型尿急）。
48例连续抱怨尿急的患者完成了两份旨在回答上述问题的不同问卷。患者被分为两组，每组24人。在重测时，第1组在3至10天内两次完成问卷1，第2组对问卷2做同样的操作。在第二次发放问卷时，每个受试者交叉回答另一份问卷。对于重测，由于数据集是二分法（是/否），通过计算kappa系数评估两组数据之间的一致性程度。
有37名女性和11名男性，年龄在54至87岁之间。两组之间的年龄和性别无差异（P = 0.19）。两份问卷的重测回答具有极好的一致性（kappa = 1.0，P < 0.001）。对于问卷1，33例（68.8%）的冲动感觉是正常感觉的强化，15例（31.3%）是不同的感觉。同样，对于问卷2，34例（70.8%）是正常冲动的强化，14例（29.2%）是不同的感觉。两组患者回答的差异不显著。在交叉部分，48名受试者中只有1人改变了回答，导致一致性程度非常高（kappa = 0.95，p < 0.001）。将两组合并，48例患者中有33例（69%）将尿急视为正常排尿冲动的强化，14例（29%）有不同的感觉，1例（2%）不确定。
尿急至少由两种不同的感觉组成。一种是正常排尿冲动的强化，另一种是不同的感觉。这种区分的意义很重要，因为它们可能有不同的病因，对治疗的反应也不同。
