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难治性膀胱过度活动症症状女性的尿动力学检查结果

Urodynamic findings in women with refractory overactive bladder symptoms.

作者信息

Al-Zahrani Ali A, Gajewski Jerzy

机构信息

Department of Urology, College of Medicine, King Fahd Hospital, University of Dammam, Dammam, Saudi Arabia.

Department of Urology, Dalhousie University, Halifax, Nova Scotia, Canada.

出版信息

Int J Urol. 2016 Jan;23(1):75-9. doi: 10.1111/iju.12954. Epub 2015 Sep 28.

Abstract

OBJECTIVES

To assess: (i) the correlation between overactive bladder symptoms and urodynamic findings in female patients; and (ii) the association of urinary symptoms with the presence of detrusor overactivity and/or bladder outlet obstruction.

METHODS

The present retrospective study included female patients with overactive bladder symptoms who underwent urodynamic evaluation by a single physician. Patients with previous anti-incontinence surgery or neurogenic bladder were excluded. Spearman's correlation coefficients were calculated to correlate overactive bladder symptoms with the urodynamic findings. Univariate and multivariate logistic regression analyses were used to determine the independent factors for detrusor overactivity and bladder outlet obstruction.

RESULTS

Overall, 1737 reports were analyzed. All patients had urgency with or without urgency urinary incontinence. Urgency, urgency urinary incontinence and nocturia correlated with detrusor overactivity. The severity of frequency, nocturia and slow stream correlated with bladder outlet obstruction. In contrast, stress urinary incontinence showed an inverse, but weak, correlation with bladder outlet obstruction. Stress urinary incontinence correlated moderately with urine leak. Storage symptoms showed an inverse, but weak, correlation with maximum cystometric capacity. Multivariate analysis data showed that age, urgency, urgency urinary incontinence and nocturia were independent predictors of detrusor overactivity, whereas the severity of frequency was a predictor of bladder outlet obstruction.

CONCLUSION

As overactive bladder symptoms increase in severity, female patients tend to have a smaller bladder capacity and a higher incidence of detrusor overactivity. A significant number of these patients have bladder outlet obstruction.

摘要

目的

评估:(i)女性患者膀胱过度活动症症状与尿动力学检查结果之间的相关性;以及(ii)尿路症状与逼尿肌过度活动和/或膀胱出口梗阻之间的关联。

方法

本回顾性研究纳入了由一名医生进行尿动力学评估的有膀胱过度活动症症状的女性患者。排除既往有抗尿失禁手术或神经源性膀胱的患者。计算Spearman相关系数以关联膀胱过度活动症症状与尿动力学检查结果。采用单因素和多因素逻辑回归分析来确定逼尿肌过度活动和膀胱出口梗阻的独立因素。

结果

总体而言,共分析了1737份报告。所有患者均有尿急,伴或不伴有急迫性尿失禁。尿急、急迫性尿失禁和夜尿与逼尿肌过度活动相关。尿频、夜尿和尿流缓慢的严重程度与膀胱出口梗阻相关。相比之下,压力性尿失禁与膀胱出口梗阻呈负相关,但相关性较弱。压力性尿失禁与尿液渗漏中度相关。储尿期症状与最大膀胱测压容量呈负相关,但相关性较弱。多因素分析数据显示,年龄、尿急、急迫性尿失禁和夜尿是逼尿肌过度活动的独立预测因素,而尿频的严重程度是膀胱出口梗阻的预测因素。

结论

随着膀胱过度活动症症状严重程度的增加,女性患者的膀胱容量往往较小,逼尿肌过度活动的发生率较高。这些患者中有相当一部分存在膀胱出口梗阻。

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