George N J, Feneley R C, Roberts J B
Br J Urol. 1986 Jun;58(3):290-5. doi: 10.1111/j.1464-410x.1986.tb09057.x.
Twenty-five patients with "prostatism" and chronic retention of urine have been followed up for 4 years to determine the natural history of the disorder and results of elective treatment. Twenty-one patients with low pressure during bladder filling maintained normal upper tracts and renal function; they were subdivided by micturition pressure into two groups which differed significantly in terms of both total bladder capacity and variance of capacity. Patients with good voiding pressures had a very satisfactory outcome following surgery, with almost complete relief of symptoms, but patients with poor voiding pressures obtained a poor symptomatic and urodynamic result from repeated surgical procedures. Four patients declined operation and the subsequent course of the disorder is described. Four patients had painless retention associated with high pressure bladder filling, hydronephrosis and uraemia. Operation was successful in reversing these potentially terminal complications. None of the 25 patients developed acute retention. Men with "prostatism" do not constitute a homogeneous population. Identification of specific patient groups enables an accurate prediction of the consequences of both conservative and operative management.
对25例患有“前列腺增生症”和慢性尿潴留的患者进行了4年的随访，以确定该疾病的自然病程和选择性治疗的结果。21例膀胱充盈期压力较低的患者上尿路和肾功能保持正常；根据排尿压力将他们分为两组，这两组在膀胱总容量和容量变化方面均有显著差异。排尿压力良好的患者术后效果非常令人满意，症状几乎完全缓解，但排尿压力差的患者经反复手术治疗后症状和尿动力学结果均较差。4例患者拒绝手术，并描述了疾病的后续病程。4例患者有无痛性尿潴留，伴有膀胱充盈高压、肾积水和尿毒症。手术成功逆转了这些潜在的终末期并发症。25例患者均未发生急性尿潴留。患有“前列腺增生症”的男性并非同质化群体。识别特定患者群体有助于准确预测保守治疗和手术治疗的后果。
