Department of Urology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Department of Urology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Urology. 2014 Mar;83(3):563-9. doi: 10.1016/j.urology.2013.10.033. Epub 2013 Dec 25.
To develop a urodynamic study (UDS) pattern system for aged male patients who complained of non-neurogenic lower urinary tract symptoms (LUTS) to create a reference guideline for their diagnosis and treatment by a retrospective analysis.
A retrospective analysis of UDS data was carried out in 1984 male patients neurologically intact with symptoms suggestive of bladder outlet obstruction (BOO) aged older than 45 years (2002-2013). On the basis of their UDS characteristic findings, the patients were classified into 1 of 7 subgroups: equivocal or mild BOO with sphincter synergia with or without idiopathic detrusor overactivity (pattern A); equivocal or mild BOO with idiopathic sphincter overactivity (B); classic BOO with sphincter synergia (C) or overactivity (D); BOO with only detrusor low compliance (E); BOO with both detrusor underactivity and low compliance (F); and equivocal BOO with detrusor underactivity (G). The follow-up data were reviewed and analyzed thereafter.
The feasibility and rationality of this system were confirmed. The distribution of 7 patterns (pattern, case number, %) was A 158, 8%; B 59, 3%; C 1059, 53.3%; D 277, 14%; E 120, 6%; F 93, 4.7%; and G 218, 11%. A-G numbers in pattern C, D, and E were 103.1-141.4, higher than other patterns (P <.001), and functional pressure lengths of pattern C and D were 7.0-7.2 cm, longer than other patterns (P <.001).
A practical UDS pattern system for aged male patients with lower urinary tract symptoms suggestive of BOO was constructed, which can be used to optimize the diagnosis and treatment of these patients.
通过回顾性分析，为年龄较大（＞45 岁）、有非神经源性下尿路症状（LUTS）但无神经损伤的男性患者建立一种新的尿动力学检查（UDS）模式系统，为其诊断和治疗提供参考依据。
回顾性分析 1984 例年龄＞45 岁、有膀胱出口梗阻（BOO）症状且无神经损伤的男性患者的 UDS 数据。根据 UDS 特征，将患者分为 7 种亚组之一：有或无特发性逼尿肌过度活动的可疑或轻度 BOO 并伴有协同收缩（A 型）；伴有或不伴有特发性括约肌过度活动的可疑或轻度 BOO（B 型）；伴有协同收缩的典型 BOO（C 型）或伴有过度活动的典型 BOO（D 型）；仅有逼尿肌顺应性降低的 BOO（E 型）；逼尿肌收缩力减弱合并顺应性降低的 BOO（F 型）；逼尿肌收缩力减弱的可疑 BOO（G 型）。然后回顾性分析随访资料。
该系统具有可行性和合理性。7 种模式（模式，例数，%）的分布为 A 型 158 例（8%），B 型 59 例（3%），C 型 1059 例（53.3%），D 型 277 例（14%），E 型 120 例（6%），F 型 93 例（4.7%），G 型 218 例（11%）。C、D、E 型的病例数分别为 103.1-141.4 例，高于其他类型（P＜0.001），且 C、D 型的功能压力长度为 7.0-7.2 cm，长于其他类型（P＜0.001）。
建立了一种实用的、针对有 BOO 症状的老年男性患者的 UDS 模式系统，有助于优化此类患者的诊断和治疗。
