Nowakowski Ł, Futyma K, Ziętek A, Bogusiewicz M, Gałczyński K, Rechberger T
Second Department of Gynaecology, Medical University of Lublin, Lublin, Poland.
Second Department of Gynaecology, Medical University of Lublin, Lublin, Poland.
Eur J Obstet Gynecol Reprod Biol. 2016 Dec;207:137-140. doi: 10.1016/j.ejogrb.2016.10.054. Epub 2016 Nov 8.
To determine if pressure-flow study (PFS) parameters, including flow index (FI) calculated by dividing average urethral flow by maximal urethral flow, increase the accuracy of urodynamic studies in the diagnosis of overactive bladder (OAB).
Retrospective study to evaluate the medical history and urodynamic examination results of female patients diagnosed with lower urinary tract symptoms (LUTS) between January 2014 and December 2015. Patients were stratified into four groups depending on the type of LUTS: OAB; stress urinary incontinence (SUI); mixed urinary incontinence with predominant SUI symptoms (MUI-SUI); and mixed urinary incontinence with predominant OAB symptoms (MUI-OAB).
OAB was diagnosed in 26 (15%) patients, SUI was diagnosed in 93 (52%) patients, MUI-OAB was diagnosed in 43 (24%) patients, and MUI-SUI was diagnosed in 17 (9%) patients. FI calculated using free uroflowmetry (FI-free) was significantly lower in the OAB group compared with the other groups (p<0.01). Analysis revealed no difference in FI-free between the SUI, MUI-SUI and MUI-OAB groups. Significant differences were found between the study groups for most free uroflowmetric parameters, including maximal urethral flow, average urethral flow and micturition volume (p<0.05). Similar differences were not found in PFS parameters.
The decrease in the urethral lumen due to the presence of a transurethral catheter in patients with OAB, in contrast to women with SUI and MUI, was not found to influence FI calculated using free uroflowmetry or PFS. FI may serve as an important objective diagnostic tool for OAB, but only when calculated from free uroflowmetry parameters when assessing patients with LUTS.
确定压力-流率研究（PFS）参数，包括通过平均尿道流量除以最大尿道流量计算得出的流率指数（FI），是否能提高尿动力学研究在诊断膀胱过度活动症（OAB）中的准确性。
一项回顾性研究，旨在评估2014年1月至2015年12月期间被诊断为下尿路症状（LUTS）的女性患者的病史和尿动力学检查结果。根据LUTS类型将患者分为四组：OAB；压力性尿失禁（SUI）；以SUI症状为主的混合性尿失禁（MUI-SUI）；以及以OAB症状为主的混合性尿失禁（MUI-OAB）。
26例（15%）患者被诊断为OAB，93例（52%）患者被诊断为SUI，43例（24%）患者被诊断为MUI-OAB，17例（9%）患者被诊断为MUI-SUI。与其他组相比，OAB组使用自由尿流率测定法计算的FI（FI-free）显著更低（p<0.01）。分析显示，SUI、MUI-SUI和MUI-OAB组之间的FI-free没有差异。在大多数自由尿流率参数方面，包括最大尿道流量、平均尿道流量和排尿量，研究组之间存在显著差异（p<0.05）。在PFS参数方面未发现类似差异。
与SUI和MUI女性患者相比，OAB患者因存在经尿道导管导致尿道腔减小，并未发现会影响使用自由尿流率测定法或PFS计算的FI。FI可能是OAB的一项重要客观诊断工具，但仅在根据自由尿流率参数计算时，用于评估LUTS患者。
