Bristol Urological Institute, Southmead Hospital, Bristol, UK.
Astellas Pharma Europe B.V., Leiden, The Netherlands.
Eur Urol. 2016 Feb;69(2):361-9. doi: 10.1016/j.eururo.2015.08.014. Epub 2015 Aug 28.
The clinical diagnosis of detrusor underactivity (DU) is hampered by the need for invasive pressure flow studies (PFS) in combination with a lack of knowledge of the associated signs and symptoms. This has contributed to a lack of awareness of DU and underactive bladder, and to the assumption that symptoms are always due to bladder outlet obstruction (BOO).
To investigate the signs and symptoms recorded in a large urodynamic database of patients who met the diagnoses of DU, BOO, and normal, to identify the clinical features associated with DU.
DESIGN, SETTING, AND PARTICIPANTS: From the database of 28282 adult PFS records, 1788 patients were classified into: (1) those with DU without BOO; (2) those with BOO without DU; and (3) those with normal PFS.
Patients with DU reported a statistically significantly higher occurrence of decreased and/or interrupted urinary stream, hesitancy, feeling of incomplete bladder emptying, palpable bladder, and absent and/or decreased sensation compared with patients with normal PFS. Other differences were found between men with DU and BOO, and between women with DU and normal PFS.
There are signs and symptoms that can distinguish DU patients from patients with normal PFS and further distinguish between DU and BOO, which is traditionally invasively diagnosed. This is a first step to better understand the clinical presentation of DU patients, is consistent with the recent underactive bladder working definition, and justifies further exploration of the signs and symptoms of DU.
The clinical diagnosis of detrusor underactivity is hampered by the need for invasive urodynamics in combination with a lack of knowledge of the associated signs and symptoms. This study has shown that there are signs and symptoms that can distinguish men and women patients with DU from patients with either normal urodynamic studies or with BOO.
由于需要进行侵入性压力流研究（PFS），并且缺乏对相关体征和症状的了解，因此对逼尿肌活动低下（DU）的临床诊断受到了阻碍。这导致人们对 DU 和低活动膀胱的认识不足，并认为症状总是由于膀胱出口梗阻（BOO）引起的。
研究在大量满足 DU、BOO 和正常诊断的患者的尿动力学数据库中记录的体征和症状，以确定与 DU 相关的临床特征。
设计、设置和参与者：从 28282 例成人 PFS 记录的数据库中，将 1788 例患者分为：（1）无 BOO 的 DU 患者；（2）无 DU 的 BOO 患者；和（3）正常 PFS 患者。
与正常 PFS 患者相比，DU 患者报告尿流减少和/或中断、犹豫、感觉膀胱排空不完全、可触及的膀胱以及感觉缺失和/或减少的发生率存在统计学显著差异。还发现了 DU 男性与 BOO 男性之间以及 DU 女性与正常 PFS 女性之间的其他差异。
有一些体征和症状可以将 DU 患者与正常 PFS 患者区分开来，进一步区分 DU 与传统上需要侵入性诊断的 BOO。这是更好地理解 DU 患者临床表现的第一步，与最近的低活动膀胱工作定义一致，并证明进一步探索 DU 的体征和症状是合理的。
由于需要进行侵入性尿动力学检查，再加上对相关体征和症状的了解不足，因此对逼尿肌活动低下（DU）的临床诊断受到了阻碍。本研究表明，有一些体征和症状可以区分 DU 男性和女性患者与正常 PFS 或 BOO 患者。
