Artibani Walter, Cerruto Maria A
Urology Clinic, University Hospital of Verona, Verona, Italy.
Curr Opin Urol. 2014 Jul;24(4):330-5. doi: 10.1097/MOU.0000000000000074.
Female dysfunctional voiding (FDV) is an intermittent and/or fluctuating flow rate due to involuntary intermittent contractions of the periurethral striated or levator muscles during voiding in neurologically normal women. Despite its codified definition, because of variable causes, there is a lack of established diagnostic criteria and management. The aim of this study is to give a comprehensive, brief review of the most recent progress in the diagnosis and management of FDV.
Currently, there is the need to shed light on several issues in FDV, such as the use of standardized definitions, diagnostic criteria, and treatment modalities. The evaluation of the progress on these matters within 2013 helped to define some key advances in the field of female functional voiding dysfunction and urinary retention.
In 2013, many diagnostic and therapeutic questions in female voiding dysfunction remain unsolved. However, some data began to emerge. Patients with FDV did not demonstrate a difference in effortful control (effortful control is the ability to regulate one's responses to external stimuli), but did demonstrate a higher rate of surgency (surgency is a trait aspect of emotional reactivity in which a person tends towards high levels of positive affect). Toilet training method in childhood does not seem to have any long-term correlation with FDV. Training with pelvic floor physiotherapy and biofeedback still represents the first-line treatment for FDV. In the management of other causes of female voiding dysfunction, sacral neuromodulation demonstrated a satisfying long-term efficacy in the treatment of nonobstructive urinary retention.
女性功能性排尿障碍（FDV）是指神经功能正常的女性在排尿过程中，由于尿道周围横纹肌或提肌的不自主间歇性收缩导致的间歇性和/或波动性尿流率。尽管其定义已被编纂，但由于病因多样，缺乏既定的诊断标准和治疗方法。本研究旨在对FDV诊断和治疗的最新进展进行全面简要的综述。
目前，需要阐明FDV中的几个问题，如标准化定义的使用、诊断标准和治疗方式。对2013年内这些问题进展的评估有助于明确女性功能性排尿障碍和尿潴留领域的一些关键进展。
2013年，女性排尿障碍中的许多诊断和治疗问题仍未解决。然而，一些数据开始出现。FDV患者在努力控制方面（努力控制是指调节对外部刺激反应的能力）没有差异，但在紧急性方面（紧急性是情绪反应性的一个特质方面，其中一个人倾向于高水平的积极情绪）显示出更高的发生率。儿童时期的如厕训练方法似乎与FDV没有任何长期关联。盆底物理治疗和生物反馈训练仍然是FDV的一线治疗方法。在治疗女性排尿障碍的其他病因时，骶神经调节在治疗非梗阻性尿潴留方面显示出令人满意的长期疗效。
