Bromage Stephen J, Dorkin Trevor J, Chan Lewis, Tse Vincent
Department of Urology, Concord Repatriation General Hospital, Sydney, Australia.
Int Urogynecol J. 2010 Sep;21(9):1117-21. doi: 10.1007/s00192-010-1113-5. Epub 2010 Jun 15.
We hypothesized that urinary symptoms in elderly females correlate poorly with urodynamic diagnosis, which would impact on management.
Charts of 53 consecutive females over age 80 undergoing multichannel urodynamics according to the International Continence Society standards were retrospectively analyzed.
Median age was 83 years. Urodynamic stress incontinence was the most common diagnosis, in 26/53 (49%). Detrusor overactivity was found in only 12 (29%) of 42 females presenting with pure storage symptoms, and reduced compliance was seen in eight (19%). Urodynamics resulted in complete change in patient management in 43% of cases and helped 52% of referring physicians in confirming provisional diagnosis prior to drug or surgical treatment.
In octogenarian females, there is poor correlation between storage symptoms and urodynamic diagnosis. Thus, urodynamics guides patient management and may avoid empirical prescribing associated with adverse effects in this clinically vulnerable population.
我们假设老年女性的泌尿系统症状与尿动力学诊断的相关性较差,这会对治疗管理产生影响。
回顾性分析了53例连续的80岁以上女性患者的病历,这些患者均按照国际尿失禁学会标准接受了多通道尿动力学检查。
中位年龄为83岁。尿动力学压力性尿失禁是最常见的诊断结果,在53例患者中有26例(49%)。在42例仅表现为储尿期症状的女性患者中,仅12例(29%)发现逼尿肌过度活动,8例(19%)出现顺应性降低。尿动力学检查导致43%的病例的患者治疗管理发生了彻底改变,并帮助52%的转诊医生在药物或手术治疗前确认初步诊断。
在八旬老年女性中,储尿期症状与尿动力学诊断之间的相关性较差。因此,尿动力学检查指导患者治疗管理,并可避免在这个临床脆弱人群中进行与不良反应相关的经验性用药。