Staskin D R
Urodynamics and Continence Center, Beth Israel Hospital, Boston, Massachusetts.
Urol Clin North Am. 1991 May;18(2):309-16.
The hypothesis that upper tract changes in the absence of vesicoureteral reflux are a function of chronically elevated intravesical pressure has had increasing impact on the management of the lower urinary tract in patients with lower tract dysfunction secondary to neurogenic bladder disease. The application of our growing ability to measure bladder and bladder outlet function objectively and in a more physiologic manner through expanding urodynamic techniques will continue to provide information that can be applied to the diagnosis and treatment of lower urinary tract dysfunction and hydroureteronephrosis after spinal cord injury. Current methods of classifying lower urinary tract behavior have not provided the ability to identify accurately those patients at greatest risk for upper tract deterioration. The application of new techniques and the use of new measures may increase our ability to identify these patients.
在没有膀胱输尿管反流的情况下，上尿路变化是膀胱内压力长期升高所致，这一假说对继发于神经源性膀胱疾病的下尿路功能障碍患者的下尿路管理产生了越来越大的影响。通过不断扩展尿动力学技术，我们越来越有能力以更生理的方式客观地测量膀胱和膀胱出口功能，这将继续为脊髓损伤后下尿路功能障碍和肾输尿管积水的诊断和治疗提供可用信息。目前对下尿路行为进行分类的方法尚无法准确识别那些上尿路恶化风险最高的患者。新技术的应用和新测量方法的使用可能会增强我们识别这些患者的能力。
