Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2010 Feb;25(2):272-5. doi: 10.3346/jkms.2010.25.2.272. Epub 2010 Jan 19.
The goal of this study was to evaluate the clinical and urodynamic features in Korean men with lower urinary tract symptoms (LUTS) and to determine non-invasive parameters for predicting bladder outlet obstruction (BOO). Four hundred twenty nine Korean men with LUTS over 50 yr of age underwent clinical evaluations for LUTS including urodynamic study. The patients were divided into two groups according to the presence of BOO. These two groups were compared with regard to age, the results of the uroflowmetry, serum prostate-specific antigen (PSA) level, prostate volume, International Prostate Symptom Score (I-PSS), and the results of the urodynamic study. Patients with BOO had a lower maximal flow rate (Q(max)), lower voided volume, higher serum PSA level and larger prostate volume (P<0.05). BOO group had a significantly higher rate of involuntary detrusor contraction and poor compliance compared to the patients without BOO (P<0.05). The multivariate analysis showed that Q(max) and poor compliance were significant factors for predicting BOO. Our results show that Q(max) plays a significant role in predicting BOO in Korean men with LUTS. In addition, BOO is significantly associated with detrusor dysfunction, therefore, secondary bladder dysfunction must be emphasized in the management of male patients with LUTS.
本研究旨在评估韩国中老年男性下尿路症状(LUTS)的临床和尿动力学特征,并确定用于预测膀胱出口梗阻(BOO)的无创参数。429 名 50 岁以上有 LUTS 的韩国男性接受了 LUTS 的临床评估,包括尿动力学研究。根据是否存在 BOO 将患者分为两组。比较两组患者的年龄、尿流率、血清前列腺特异性抗原(PSA)水平、前列腺体积、国际前列腺症状评分(I-PSS)和尿动力学检查结果。BOO 组的最大尿流率(Qmax)较低,排尿量较少,血清 PSA 水平较高,前列腺体积较大(P<0.05)。与无 BOO 的患者相比,BOO 组患者出现不随意逼尿肌收缩和顺应性差的比例显著更高(P<0.05)。多变量分析显示,Qmax 和顺应性差是预测 BOO 的显著因素。我们的结果表明,Qmax 在预测韩国男性 LUTS 患者的 BOO 中起重要作用。此外,BOO 与逼尿肌功能障碍显著相关,因此,在管理男性 LUTS 患者时必须强调继发性膀胱功能障碍。