Gupta Anupam, Taly Arun B, Srivastava Abhishek, Thyloth Murali
Department of Psychiatric and Neurological Rehabilitation, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India.
Ann Indian Acad Neurol. 2009 Apr;12(2):104-7. doi: 10.4103/0972-2327.53078.
Assessment of bladder by urodynamic study (UDS) in patients with urinary incontinence following stroke, and correlation with site of lesion.
Retrospective cross-sectional study in the neurological rehabilitation unit of a tertiary care institute.
Forty patients (22 males) with arterial or venous, ischemic or hemorrhagic stroke, with urinary incontinence in the acute phase following the event, underwent UDS. Seventeen patients had right hemiplegia, 18 had left hemiplegia, and five had posterior circulation stroke with brainstem/cerebellar features. Bladder type was correlated with age, side, and site of lesion.
The mean age was 46.80 +/- 16.65 years (range: 18-80 years). Thirty-six patients had arterial stroke and four had cortical venous thrombosis. UDS was performed after a mean of 28.32 +/- 10.27 days (range: 8-53 days) after the stroke. All but one patient had neurogenic bladder dysfunction, with 36 patients (90%) having overactive detrusor (OD) and three having underactive/areflexic detrusor. Among the 36 patients with OD, 25 patients (62.5%) had OD without detrusor-sphincter dyssynergy (DSD) and 11 (27.5%) had OD with DSD. Bladder management was advised based on the UDS findings. No significant correlation (P > 0.05) was found between type of bladder and age or side and site of lesion.
UDS is a useful tool to assess and manage the bladder following stroke with urinary incontinence. In this study, no significant correlation was found between UDS findings and site of lesion.
通过尿动力学研究(UDS)评估中风后尿失禁患者的膀胱情况,并分析其与病变部位的相关性。
在一家三级医疗机构的神经康复科进行的回顾性横断面研究。
40例(22例男性)发生动脉或静脉性、缺血性或出血性中风且急性期出现尿失禁的患者接受了UDS检查。17例患者为右侧偏瘫,18例为左侧偏瘫,5例为具有脑干/小脑特征的后循环中风。膀胱类型与年龄、偏瘫侧及病变部位相关。
平均年龄为46.80±16.65岁(范围:18 - 80岁)。36例患者为动脉性中风,4例为皮质静脉血栓形成。中风后平均28.32±10.27天(范围:8 - 53天)进行了UDS检查。除1例患者外,所有患者均存在神经源性膀胱功能障碍,其中36例(90%)逼尿肌过度活动(OD),3例逼尿肌活动低下/无反射。在36例OD患者中,25例(62.5%)为无逼尿肌-括约肌协同失调(DSD)的OD,11例(27.5%)为伴有DSD的OD。根据UDS检查结果给出膀胱管理建议。未发现膀胱类型与年龄、偏瘫侧及病变部位之间存在显著相关性(P>0.05)。
UDS是评估和管理中风后尿失禁患者膀胱的有用工具。在本研究中,未发现UDS检查结果与病变部位之间存在显著相关性。