Jensen K M, Jørgensen J B, Mogensen P
Department of Urology D, Bispebjerg Hospital, Copenhagen, Denmark.
Scand J Urol Nephrol Suppl. 1988;114:78-83.
The influence of preoperative cystometric findings on the post-surgical outcome in prostatism was examined in a prospective study comprising 139 consecutive patients. A blinded study design was used, including an entirely non-urodynamic selection procedure for prostatic surgery. In addition an extensive urodynamic investigation was carried out including: spontaneous uroflowmetry, medium-fill water cystometry and pressure-flow study combined with stop-flow test. All patients were re-evaluated 6 months postoperatively, both symptomatologically and urodynamically. The patients were classified in three groups according to the preoperative detrusor function: normal, overactive in the standing position and overactive in the supine position. No significant urodynamic nor symptomatologic differences were shown, neither pre- nor postoperatively. Nor did the subjective outcome differ between the groups. Demonstration of postoperative (persistent) detrusor instability was associated with an unfavourable subjective outcome. While residual urine had no predictive importance, a preoperative maximum cystometric capacity less than 300 ml appeared to indicate postoperative failure. Significant association was found between urge and detrusor instability. In conclusion, cystometry is not worthwhile in the preoperative work-up in prostatism.
在一项纳入139例连续患者的前瞻性研究中，研究了术前膀胱测压结果对前列腺增生症手术预后的影响。采用了盲法研究设计，包括前列腺手术完全非尿动力学的选择程序。此外，还进行了广泛的尿动力学检查，包括：自主尿流率测定、中量充盈膀胱测压以及结合阻断流试验的压力-流率研究。所有患者在术后6个月进行了症状学和尿动力学的重新评估。根据术前逼尿肌功能将患者分为三组：正常、站立位时过度活跃和仰卧位时过度活跃。术前和术后均未显示出显著的尿动力学和症状学差异。各组之间的主观预后也没有差异。术后（持续性）逼尿肌不稳定的表现与不良的主观预后相关。虽然残余尿量没有预测价值，但术前最大膀胱测压容量小于300 ml似乎提示术后预后不良。尿急与逼尿肌不稳定之间存在显著关联。总之，膀胱测压在前列腺增生症的术前检查中没有价值。
