Shohada-e-Tajrish hospital, Shahid Beheshti University, M.C. (SBMU), Tehran, IR, Iran.
Neurourol Urodyn. 2011 Nov;30(8):1580-5. doi: 10.1002/nau.21095. Epub 2011 Jul 20.
To assess frequency of urodynamic abnormalities in young men with chronic lower urinary tract symptoms (LUTS).
We assessed 456 men (18-40 years old) with chronic LUTS. Those with the history of urogenital malignancies, neurological disease, urethral stricture or trauma, acute UTI, congenital urological disease, and diabetes mellitus were excluded. Patients were classified by special urodynamic diagnosis.
Mean patient age was 25.8 ± 5.9 years old and the mean symptom duration was 12.3 ± 3.2 months. Urodynamic studies showed bladder neck dysfunction in 96 of cases (21%), dysfunctional voiding in 69 (15.1%), detrusor overactivity in 62 (13.6%), small cystometric capacity in 49 (10.7%), and acontractile detrusor in 48 (10.5%), underactive detrusor in 11 (2.4%), low compliance in 18 (3.9%), detrusor overactivity plus acontractile detrusor in 6 (1.3%), low compliance plus small cystometric capacity in 5 (1.0%), detrusor overactivity plus small cystometric capacity together with low compliance in 4 (0.8%), low compliance plus Underactive detrusor in 3 (0.6%) and normal urodynamics in 85 (18.6%). Mean Q(max) in patients with bladder neck dysfunction, dysfunctional voiding, underactive detrusor, acontractile detrusor, underactive detrusor plus low compliance, and acontractile detrusor plus detrusor overactivity were lower than those of the other groups. Mean postvoid residues in patients with underactive detrusor, and underactive detrusor plus low compliance, were higher than those in the remaining groups. Positive four-glass test in patient with normal urodynamic was greater than those in the remaining groups.
A few clinical symptoms or noninvasive tests were useful in young men with chronic LUTS; hence, urodynamics are advised to make the correct diagnosis in this regard.
评估慢性下尿路症状（LUTS）年轻男性患者的尿动力学异常频率。
我们评估了 456 名（18-40 岁）慢性 LUTS 男性患者。排除了有泌尿生殖系统恶性肿瘤、神经疾病、尿道狭窄或外伤、急性尿路感染、先天性泌尿系统疾病和糖尿病病史的患者。根据特殊尿动力学诊断对患者进行分类。
患者平均年龄为 25.8±5.9 岁，平均症状持续时间为 12.3±3.2 个月。尿动力学研究显示，96 例（21%）患者存在膀胱颈功能障碍，69 例（15.1%）存在排尿功能障碍，62 例（13.6%）存在逼尿肌过度活动，49 例（10.7%）存在膀胱容量小，48 例（10.5%）存在逼尿肌无力，11 例（2.4%）存在逼尿肌无力，18 例（3.9%）存在顺应性低，6 例（1.3%）存在逼尿肌过度活动合并逼尿肌无力，5 例（1.0%）存在顺应性低合并膀胱容量小，4 例（0.8%）存在逼尿肌过度活动合并膀胱容量小和顺应性低，3 例（0.6%）存在顺应性低合并逼尿肌无力，85 例（18.6%）存在正常尿动力学。膀胱颈功能障碍、排尿功能障碍、逼尿肌无力、逼尿肌无力、逼尿肌无力合并顺应性低和逼尿肌过度活动患者的最大尿流率（Q(max)）均低于其他组。逼尿肌无力和逼尿肌无力合并顺应性低患者的残余尿量均高于其余组。正常尿动力学患者的四杯试验阳性率大于其余组。
少数临床症状或非侵入性检查在慢性 LUTS 年轻男性中具有一定的诊断价值，因此建议进行尿动力学检查以明确诊断。
