Wu Di, Rosedale Richard
a Physiothérapie Polyclinique Cabrini , Montreal , Quebec , Canada.
b Occupational Health and Safety , London Health Sciences Centre , London , Ontario , Canada.
Physiother Theory Pract. 2019 Apr;35(4):383-391. doi: 10.1080/09593985.2018.1443359. Epub 2018 Feb 26.
Lower urinary tract symptoms (LUTS) are highly prevalent among men over the age of 40. Even though associations between lumbar spine conditions and LUTS have been documented in the literature, no studies have detailed a specific lumbar assessment and classification process, and the related treatment effects in patients with LUTS. In this case series, we present three male patients with LUTS as primary complaints, who were evaluated and treated with Mechanical Diagnosis and Therapy (MDT) for the lumbar spine. The duration of their symptoms was between 4 months and 7 years. Urogenital pathologies were ruled out for all patients. The Chronic Prostatitis Symptom Index was used as a functional outcome measure. All patients were classified as having lumbar derangements. Treatment of derangements with directional preference exercises resulted in the improvement of their LUTS, with clinically significant improvements (56.0%-77.4%) in functional outcome measures over an average of six sessions. Preliminary indications suggest that these LUTS cases may possibly have had a lumbar spine origin and "mechanical" nature. Therefore, they may be within the scope of MDT assessments and interventions. With careful monitoring of symptoms, MDT may serve as a screening tool and conservative treatment option.
下尿路症状（LUTS）在40岁以上男性中极为普遍。尽管腰椎疾病与LUTS之间的关联已在文献中有所记载，但尚无研究详细阐述具体的腰椎评估和分类过程，以及LUTS患者的相关治疗效果。在本病例系列中，我们介绍了3例以LUTS为主诉的男性患者，他们接受了腰椎的力学诊断与治疗（MDT）评估及治疗。其症状持续时间在4个月至7年之间。所有患者均排除了泌尿生殖系统病变。采用慢性前列腺炎症状指数作为功能转归指标。所有患者均被归类为腰椎紊乱。采用有方向偏好练习对紊乱进行治疗，使他们的LUTS得到改善，平均经过6次治疗后，功能转归指标有显著的临床改善（56.0%-77.4%）。初步迹象表明，这些LUTS病例可能源于腰椎且具有“力学”性质。因此，它们可能属于MDT评估和干预的范畴。通过对症状的密切监测，MDT可作为一种筛查工具和保守治疗选择。
