Panikratov K D, Strel'nikov A I
Urol Nefrol (Mosk). 1989 Jan-Feb(1):41-6.
Functional activity of the lower and upper urinary tract was examined in 169 patients with infravesical obstruction and in 20 controls. Combined investigation included: radioisotope uroflowmetry, retrograde cystomanometry, urethrosphincterometry, miction videocystourethrography, excretory urography, radioisotope renography, pharmacorenography, dynamic nephroscintigraphy and renal angiography. An analysis of lower urinary urodynamic findings has demonstrated stages as an important regularity in the development of functional lower urinary disturbances. As a result, a standard system has been evolved for the assessment and classification of stages in chronic lower-urinary urodynamic disorders. Four stages are identified in the classification. Evaluation of upper-urinary urodynamics in the same 169 patients with lower urinary tract disorders of varying severity demonstrated that upper urinary functional parameters become worse as lower urinary parameters deteriorate, but there is no strict correlation between those. A systematic study of the pattern of combined disorders of the lower and upper urinary tract has made it possible to develop a standard system for the assessment and classification of stages of combined urodynamic insufficiency, with 4 stages identified. The use of this system improves objective assessment of the severity of patient's condition and specifies indications for surgical treatment of infravesical obstructions.
对169例膀胱下梗阻患者及20例对照者的下尿路和上尿路功能活动进行了检查。联合检查包括：放射性核素尿流率测定、逆行膀胱测压、尿道括约肌测压、排尿期膀胱尿道造影、排泄性尿路造影、放射性核素肾图、药物肾图、动态肾闪烁扫描及肾血管造影。对下尿路尿动力学检查结果的分析表明，分期是下尿路功能障碍发展过程中的一个重要规律。因此，已形成了一套用于评估和分类慢性下尿路尿动力学障碍分期的标准系统。该分类中确定了四个阶段。对同一169例不同严重程度下尿路疾病患者的上尿路尿动力学评估表明，随着下尿路参数的恶化，上尿路功能参数也会变差，但两者之间并无严格的相关性。对下尿路和上尿路联合疾病模式的系统研究使得有可能制定一套用于评估和分类联合尿动力学功能不全分期的标准系统，其中确定了四个阶段。使用该系统可改善对患者病情严重程度的客观评估，并明确膀胱下梗阻手术治疗的指征。
