使用充盈末期逼尿肌压力监测膀胱顺应性：临床结果及相关因素。

Monitoring bladder compliance using end filling detrusor pressure: Clinical results and related factors.

作者信息

Liao Jin-Yi, Lin Yi-Hao, Liang Ching-Chung, Hsieh Wu-Chiao, Lee She-Jane, Tseng Ling-Hong

机构信息

University of Chang Gung School of Medicine, Taoyuan, Taiwan.

Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital Lin-Kou Branch and University of Chang Gung School of Medicine, Taoyuan, Taiwan.

出版信息

Taiwan J Obstet Gynecol. 2015 Dec;54(6):709-15. doi: 10.1016/j.tjog.2015.10.003.

DOI:10.1016/j.tjog.2015.10.003

PMID:26700990

Abstract

OBJECTIVE

To assess the clinical significance of low compliance bladder (LCB) in women with lower urinary tract symptoms.

MATERIALS AND METHODS

Medical records of 1490 women undergoing videourodynamic studies (VUSs) were reviewed. Comprehensive medical histories, physical examinations, bladder diaries, and results of multichannel VUS were analyzed. This study adopted an end filling detrusor pressure (EFP) greater than 20 cmH2O to define LCB.

RESULTS

Among the study patients (n = 1490), 9.1% were diagnosed with LCB using a cutoff value of 17.5 cmH2O, which had a sensitivity and specificity of 89% and 92.7%, respectively. Results of multivariate analysis indicated that age (p = 0.005), maximum cystometric capacity (MCC; p = 0.002), detrusor overactivity (DO; p = 0.001), pelvic organ prolapse (POP; p = 0.018), recurrent urinary tract infection (p = 0.001), and radical abdominal hysterectomy (RAH; p < 0.001) as independent prognostic factors. Furthermore, our study results indicate that the MCC, urinary tract infection, and a history of RAH have a positive correlation with LCB, whereas, age, POP, and DO have a negative correlation with LCB.

CONCLUSION

Our idea using EFP (≥17.5 cmH2O) for screening women with LCB is feasible for clinical use.

摘要

目的

评估低顺应性膀胱（LCB）在有下尿路症状女性中的临床意义。

材料与方法

回顾了1490例接受影像尿动力学检查（VUS）女性的病历。分析了全面的病史、体格检查、膀胱日记以及多通道VUS结果。本研究采用终末充盈期逼尿肌压力（EFP）大于20 cmH₂O来定义LCB。

结果

在研究患者（n = 1490）中，使用17.5 cmH₂O的临界值诊断出9.1%的患者患有LCB，其敏感性和特异性分别为89%和92.7%。多因素分析结果表明，年龄（p = 0.005）、最大膀胱测压容量（MCC；p = 0.002）、逼尿肌过度活动（DO；p = 0.001）、盆腔器官脱垂（POP；p = 0.018）、复发性尿路感染（p = 0.001）以及根治性腹式子宫切除术（RAH；p < 0.001）为独立的预后因素。此外，我们的研究结果表明，MCC、尿路感染和RAH病史与LCB呈正相关，而年龄、POP和DO与LCB呈负相关。