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同一检测时段内对有尿失禁症状的女性进行重复膀胱测压和压力流率研究的可重复性。

Reproducibility of same session repeated cystometry and pressure-flow studies in women with symptoms of urinary incontinence.

机构信息

Department of Obstetrics & Gynecology 791, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

出版信息

Neurourol Urodyn. 2010 Mar;29(3):428-31. doi: 10.1002/nau.20783.

Abstract

AIM

The aim of this study was to determine the reproducibility of same session repeated urodynamic measurements in women with symptoms of urinary incontinence.

METHODS

Women presenting with symptoms of urinary incontinence underwent standardized urodynamic examination, which consisted of free uroflowmetry and two filling cystometries and pressure-flow studies. Intra-class Correlation Coefficient (ICC) and McNemar tests were used to describe the same session reproducibility.

RESULTS

Two evaluable urodynamic tests were available in 152 patients. Overall, reproducibility of the urodynamic parameters were good to excellent (ICC range: 0.72-0.93), except for the bladder volume at first sensation of bladder filling (ICC = 0.46) and the maximum Watt's factor (ICC = 0.68). The bladder volume at first sensation and the maximum cystometric capacity were systematically higher in the second run (mean difference (95% CI) = -45 (-73; -37) and -3 (-15; 10), respectively). Reproducibility of the diagnosis stress urinary incontinence and/or detrusor overactivity were good to excellent (median ICC = 0.76, P = 0.68 and P = 1.00, respectively). Reproducibility of the volume and amplitude at involuntary detrusor contractions, however, were only poor (ICC = 0.18 and 0.25, respectively).

CONCLUSIONS

The reproducibility of same session repeated urodynamic measurements in women with symptoms of urinary incontinence was good to excellent. Our results provide the scientific support for guidelines that recommend the omission of repeated filling cystometries and pressure-flow studies in cases where the first test confirms the pathology expected.

摘要

目的

本研究旨在确定有尿失禁症状的女性在同一次就诊中重复进行尿动力学测量的可重复性。

方法

出现尿失禁症状的女性接受了标准化的尿动力学检查,包括自由尿流率和两次充盈性膀胱测压及压力流率研究。采用组内相关系数(ICC)和 McNemar 检验来描述同次就诊的可重复性。

结果

152 例患者中有 2 例可评估的尿动力学检查。总体而言,尿动力学参数的可重复性较好至极好(ICC 范围:0.72-0.93),除了首次感觉膀胱充盈时的膀胱容量(ICC=0.46)和最大瓦氏因子(ICC=0.68)。在第二次检查中,首次感觉膀胱充盈的膀胱容量和最大膀胱测压容量系统升高(平均差值(95%CI)=-45(-73;-37)和-3(-15;10))。诊断压力性尿失禁和/或逼尿肌过度活动的可重复性较好至极好(中位数 ICC=0.76,P=0.68 和 P=1.00)。然而,不随意逼尿肌收缩时的容量和幅度的可重复性仅为差(ICC=0.18 和 0.25)。

结论

有尿失禁症状的女性在同一次就诊中重复进行尿动力学测量的可重复性较好至极好。我们的研究结果为指南提供了科学依据,指南建议在首次检查确认预期病理时,可省略重复充盈性膀胱测压及压力流率研究。

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