Giarenis Ilias, Zacchè Martino, Robinson Dudley, Cardozo Linda
Department of Urogynaecology, King's College Hospital, London, United Kingdom.
Neurourol Urodyn. 2017 Mar;36(3):780-783. doi: 10.1002/nau.23023. Epub 2016 Apr 19.
The lack of a validated detrusor overactivity (DO) severity tool limits the clinical value of urodynamics in the management of patients with overactive bladder syndrome (OAB). The aim of this study, was to identify urodynamic variables that correlate with validated OAB severity measures.
This was a cross-sectional study enrolling consecutive women with idiopathic DO. The 24 hr urgency episodes and the score of the Incontinence Impact (II) domain of the King's Health Questionnaire (KHQ) were used to assess the severity of OAB.
The study enrolled 299 women with idiopathic DO. The cystometric capacity, compliance, and the threshold volume for the first involuntary detrusor contraction (IDC) showed a statistically significant negative correlation with the II domain of the KHQ and the 24 hr urgency episodes. There was a statistically significant positive correlation between the amplitude of first IDC and the OAB severity measures, but only borderline for the amplitude of the highest IDC. There were no statistically significant differences between women with and without leakage per urethram during a detrusor contraction.
Cystometric capacity, compliance (measured in ml/cm H O), threshold volume, and amplitude of the first IDC could be routinely documented in everyday clinical practice. The measures more commonly used for describing the severity of DO, such as leakage per urethram during a detrusor contraction and amplitude of the highest detrusor contraction, have a limited role confirming the complicated interaction between the detrusor muscle, the urethral sphincter, and the pelvic floor in women. Neurourol. Urodynam. 36:780-783, 2017. © 2016 Wiley Periodicals, Inc.
缺乏经过验证的逼尿肌过度活动（DO）严重程度评估工具限制了尿动力学在膀胱过度活动症（OAB）患者管理中的临床价值。本研究的目的是确定与经过验证的OAB严重程度评估指标相关的尿动力学变量。
这是一项横断面研究，纳入连续的特发性DO女性患者。采用24小时尿急发作次数和国王健康问卷（KHQ）的尿失禁影响（II）领域评分来评估OAB的严重程度。
该研究纳入了299例特发性DO女性患者。膀胱测压容量、顺应性以及首次非自愿逼尿肌收缩（IDC）的阈值体积与KHQ的II领域及24小时尿急发作次数呈统计学显著负相关。首次IDC的幅度与OAB严重程度评估指标之间存在统计学显著正相关，但最高IDC幅度仅为临界相关。在逼尿肌收缩期间，有尿道漏尿和无尿道漏尿的女性之间无统计学显著差异。
膀胱测压容量、顺应性（以ml/cm H₂O为单位测量）、阈值体积和首次IDC的幅度可在日常临床实践中常规记录。更常用于描述DO严重程度的指标，如逼尿肌收缩期间的尿道漏尿和最高逼尿肌收缩幅度，在确认女性逼尿肌、尿道括约肌和盆底之间复杂相互作用方面作用有限。《神经泌尿学与尿动力学》36:780 - 783, 2017。© 2016威利期刊公司
