Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.
World J Urol. 2013 Dec;31(6):1463-8. doi: 10.1007/s00345-013-1081-8. Epub 2013 Apr 27.
To evaluate the clinical characteristics of patients with maximal urine flow rate (Q max) ≥ 25 ml/s complaining of lower urinary tract symptoms (LUTS), using propensity score-matching analysis to compare with the control group.
Medical records from a prospectively maintained database for first visit male patients with LUTS/benign prostatic hyperplasia between 2010 and 2012 were used to select 818 patients. Of these patients, 68 men with Q max ≥ 25 ml/s were defined as the supervoider group, and 68 patients were selected for the control group using propensity scores, which were calculated for each patient using multivariable logistic regression model based on the following covariates: age, prostate volume, voided urine volume, and post-voided residual volume. International Prostate Symptom Score (IPSS), quality of life score, and Overactive Bladder Symptom Score (OABSS) were also analyzed.
Mean Q max was 30.82 ± 5.13 in supervoiders and 15.95 ± 4.88 ml/s in controls (p < 0.001). There were statistical differences in IPSS between supervoiders and controls (12.63 ± 5.81 vs. 16.13 ± 6.90; p = 0.002). Although the IPSS voiding symptom sub-score in supervoiders was lower than controls (5.09 ± 3.35 vs. 7.40 ± 4.00; p < 0.001), there were no significant differences in storage symptom and post-micturitional symptom sub-scores. In OABSS and subdomain scores for frequency, nocturia, and urgency, there were no significant differences between the groups. However, the urge incontinence subdomain score was significantly higher in supervoiders versus controls (0.69 ± 1.26 vs. 0.18 ± 0.52; p = 0.003).
Supervoiders experience comparable levels of storage and post-micturition symptoms, but display more severe urge incontinence despite milder voiding symptoms and better uroflowmetric measurements than propensity score-matched controls.
使用倾向评分匹配分析，评估最大尿流率（Q max）≥25ml/s 且伴有下尿路症状（LUTS）的患者的临床特征，并与对照组进行比较。
回顾性分析 2010 年至 2012 年间前瞻性维护的数据库中首次就诊的伴有 LUTS/良性前列腺增生的男性患者的病历资料，共纳入 818 例患者。其中，68 例 Q max≥25ml/s 的患者被定义为超大排量组，其余 68 例患者根据多变量逻辑回归模型，基于年龄、前列腺体积、排尿量和剩余尿量等因素，采用倾向评分法进行匹配，以匹配为对照组。分析国际前列腺症状评分（IPSS）、生活质量评分和膀胱过度活动症症状评分（OABSS）。
超大排量组患者的平均 Q max 为 30.82±5.13ml/s，对照组为 15.95±4.88ml/s（p＜0.001）。超大排量组和对照组患者的 IPSS 评分存在统计学差异（12.63±5.81 分比 16.13±6.90 分；p=0.002）。尽管超大排量组患者的排尿症状 IPSS 评分低于对照组（5.09±3.35 分比 7.40±4.00 分；p＜0.001），但两组在储尿期症状和排尿后症状的 IPSS 评分方面无明显差异。OABSS 评分及其各领域评分，如频率、夜尿和急迫性等，两组间均无显著差异。然而，超大排量组患者急迫性尿失禁亚领域评分明显高于对照组（0.69±1.26 分比 0.18±0.52 分；p=0.003）。
超大排量组患者的储尿期和排尿后症状相当，但急迫性尿失禁更为严重，尽管其排尿症状较轻，尿流率测量结果更好。
