Basu Maya, Duckett Jonathan
Department of Obstetrics and Gynaecology, Medway Maritime Hospital, Windmill Road, Gillingham, Kent ME7 5NY, UK.
Int Urogynecol J Pelvic Floor Dysfunct. 2009 Sep;20(9):1073-7. doi: 10.1007/s00192-009-0904-z. Epub 2009 May 15.
The aim of this study was to assess whether urethral dilatation (UD) leads to changes in pressure flow parameters in women with voiding dysfunction (VD) and whether this correlates with improvement in overactive bladder symptoms (OAB).
Forty three women with drug-resistant OAB and VD underwent cystoscopy and UD. Pressure flow studies were undertaken at 6 weeks with further follow-up at 6 months. Any significant changes in pressure flow parameters after UD were evaluated.
Thirty three percent of the participants reported subjective improvement. This was maintained at 6 months in 19%. Improvement in OAB was associated with an increase in maximum flow rate centile (p = 0.02) and a decrease in detrusor pressure at maximum flow (p = 0.03). Thirteen percent developed urodynamic stress incontinence.
Thirty three percent of women with drug-resistant OAB have a short-term improvement following UD. Improvement is associated with an increased maximum flow rate centile and a decreased detrusor pressure at maximum flow. The long-term improvement rate is poor.
本研究旨在评估尿道扩张术(UD)是否会导致排尿功能障碍(VD)女性的压力流参数发生变化,以及这是否与膀胱过度活动症症状(OAB)的改善相关。
43例耐药性OAB和VD女性接受了膀胱镜检查和UD。在6周时进行压力流研究,并在6个月时进一步随访。评估UD后压力流参数的任何显著变化。
33%的参与者报告主观症状改善。19%的患者在6个月时仍保持改善。OAB的改善与最大尿流率百分位数增加(p = 0.02)和最大尿流时逼尿肌压力降低(p = 0.03)相关。13%的患者出现了尿动力学压力性尿失禁。
33%的耐药性OAB女性在UD后有短期改善。改善与最大尿流率百分位数增加和最大尿流时逼尿肌压力降低相关。长期改善率较低。