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使用尿动力学评估女性膀胱过度活动症:与女性排尿功能障碍的关系

Evaluation of female overactive bladder using urodynamics: relationship with female voiding dysfunction.

作者信息

Cho Kang Jun, Kim Hyo Sin, Koh Jun Sung, Kim Joon Chul

机构信息

Department of Urology, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, Korea.

出版信息

Int Braz J Urol. 2015 Jul-Aug;41(4):722-8. doi: 10.1590/S1677-5538.IBJU.2014.0195.

Abstract

PURPOSE

To investigate the role of urodynamic study (UDS) in female patients with overactive bladder (OAB) analyzing the relationship between OAB symptoms and female voiding dysfunction (FVD).

MATERIALS AND METHODS

We analyzed the clinical and urodynamic data of 163 women with OAB symptoms. OAB symptoms were categorized as dry and wet. FVD was described as detrusor underactivity (DUA), which was defined as a maximum flow rate (Qmax) of ≤ 15 mL/s associated with a detrusor pressure at Qmax (PdetQ max) of ≤ 20 cmH2O, along with bladder outlet obstruction (BOO), which was defined as a Qmax of ≤ 15 mL/s with a PdetQ max of > 20 cmH2O. Clinical and urodynamic results were compared between patients with dry and wet symptoms and between those with and without FVD.

RESULTS

78 (47.9%) had dry, and 85 (52.1%) had wet symptoms. The entire group had a relatively low Qmax (15.1 ± 6.6 mL/s) and relatively high number of BOO (42.9%, 70/163) and DUA (8.6%, 14/163). A significantly higher number of patients with wet symptoms had detrusor overactivity compared to those with dry, as detected by the UDS (p < 0.05). No significant differences were found in BOO and DUA number between dry and wet groups. Further, the international prostate symptom score did not different significantly between patients with and without FVD.

CONCLUSION

A significant number of women with OAB had voiding dysfunction. However, the OAB symptoms themselves were not useful for predicting the presence of FVD. Therefore, UDS may be necessary for accurate diagnosis in women with OAB symptoms.

摘要

目的

通过分析膀胱过度活动症(OAB)症状与女性排尿功能障碍(FVD)之间的关系,探讨尿动力学检查(UDS)在女性膀胱过度活动症患者中的作用。

材料与方法

我们分析了163例有OAB症状女性的临床和尿动力学数据。OAB症状分为干性和湿性。FVD被描述为逼尿肌活动低下(DUA),定义为最大尿流率(Qmax)≤15 mL/s且Qmax时逼尿肌压力(PdetQ max)≤20 cmH2O,以及膀胱出口梗阻(BOO),定义为Qmax≤15 mL/s且PdetQ max>20 cmH2O。比较了有干性和湿性症状患者以及有和无FVD患者的临床和尿动力学结果。

结果

78例(47.9%)有干性症状,85例(52.1%)有湿性症状。整个组的Qmax相对较低(15.1±6.6 mL/s),BOO(42.9%,70/163)和DUA(8.6%,14/163)的数量相对较高。尿动力学检查发现,有湿性症状的患者逼尿肌过度活动的数量明显高于有干性症状的患者(p<0.05)。干性和湿性组之间的BOO和DUA数量没有显著差异。此外,有和无FVD的患者之间国际前列腺症状评分没有显著差异。

结论

相当数量的OAB女性存在排尿功能障碍。然而,OAB症状本身对于预测FVD的存在并无帮助。因此,对于有OAB症状的女性,可能需要进行尿动力学检查以准确诊断。

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