Nordling J
Department of Urology, Herlev Hospital, University of Copenhagen, Denmark.
Ciba Found Symp. 1990;151:139-47; discussion 147-55. doi: 10.1002/9780470513941.ch8.
The urinary bladder has two functions: to store and to empty. A frequency-volume chart completed by the patient provides useful information about voiding intervals, possible factors provocative for incontinence, functional bladder capacity and daily urine volume. Filling cystometry is used primarily to evaluate reflex function in the storage phase, giving information about the presence or absence of detrusor instability and (in combination with urethral EMG) about detrusor-sphincter coordination. Information is also obtained about bladder sensation, bladder capacity and bladder compliance. Detrusor function during emptying is closely related to outflow conditions and therefore demands simultaneous registration of detrusor pressure and urinary flow rate. An inverse relation exists between detrusor pressure and flow rate, which means that reduced flow rate causes increased detrusor pressure for the same detrusor power. Underactive detrusor function will result in low detrusor pressure and low flow rate. The finding of a non-contractile detrusor may indicate psychogenic inhibition or a neurogenic lesion. Sacral evoked potentials and denervation supersensitivity tests may help to distinguish between these conditions.
储存尿液和排空尿液。患者填写的频率 - 容量图表可提供有关排尿间隔、可能导致尿失禁的因素、膀胱功能容量和每日尿量的有用信息。充盈性膀胱测压主要用于评估储存期的反射功能，提供有关逼尿肌不稳定是否存在的信息，以及（与尿道肌电图联合使用）有关逼尿肌 - 括约肌协调性的信息。还可获取有关膀胱感觉、膀胱容量和膀胱顺应性的信息。排尿时的逼尿肌功能与流出道情况密切相关，因此需要同时记录逼尿肌压力和尿流率。逼尿肌压力与尿流率呈反比关系，这意味着在相同逼尿肌功率下，尿流率降低会导致逼尿肌压力升高。逼尿肌功能减退会导致逼尿肌压力低和尿流率低。发现逼尿肌无收缩可能提示心理性抑制或神经源性病变。骶神经诱发电位和去神经超敏试验可能有助于区分这些情况。
