Li Xing, Liao Li-Min, Chen Guo-Qing, Wang Zhao-Xia, Lu Tian-Ji, Deng Han
The Rehabilitation School of Capital Medical University and Department of Urology at China Rehabilitation Research Centre Beijing Key Laboratory of Neural Injury and Rehabilitation and Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China.
Medicine (Baltimore). 2018 Jan;97(3):e9610. doi: 10.1097/MD.0000000000009610.
There have no universally accepted criteria and have been established for classification of underactive bladder (UAB) at present. Thus, the study described the comprehensive clinical and urodynamic characteristics of UAB in patients with lower urinary tract symptoms.A total of 1726 patients (1259 men and 467 women; 6-88 years old) who were admitted to our center with a diagnosis of UAB were included in this retrospective study. It was due to the type of rehabilitation hospital, so higher percentage of neurological patients were included. The demographics, clinical characteristics, and urodynamic recordings were reviewed. The clinical characteristics and urodynamic findings of UAB were further classified.For the etiologic analysis, UAB with aging and without clear causes accounted for 11.5% of cases (199/1726), UAB with bladder outflow obstruction accounted for 2.6% (45/1726), and UAB acting on the nerve pathway of the voiding reflex accounted for 84.6% (1460/1726). There were a number of cases (1.3% [22/1726]) which had >2 factors assigned. For studies involving urodynamic findings and clinical symptoms, the percentage of patients with detrusor hyperreflexia with impaired contractility (DHIC), detrusor underactivity (DU), and acontractile detrusor (AcD) was 0.7%, 5.6%, and 93.7%, respectively.UAB can be classified into 4 types based on possible etiologic mechanisms (idiopathic, myogenic, neurogenic, and integrative). Based on urodynamic findings and symptoms, UAB can be classified into 3 types (DU, AcD, and DHIC). The classification of UAB can provide a reasonable basis for the future research.
目前尚无普遍接受的膀胱过度活动症(UAB)分类标准。因此,本研究描述了下尿路症状患者中UAB的综合临床和尿动力学特征。本回顾性研究纳入了1726例诊断为UAB并入住本中心的患者(1259例男性和467例女性;年龄6 - 88岁)。由于本康复医院的类型,纳入了较高比例的神经科患者。回顾了患者的人口统计学、临床特征和尿动力学记录。对UAB的临床特征和尿动力学结果进行了进一步分类。病因分析显示,衰老相关且无明确病因的UAB占病例的11.5%(199/1726),膀胱出口梗阻相关的UAB占2.6%(45/1726),作用于排尿反射神经通路的UAB占84.6%(1460/1726)。有一些病例(1.3% [22/1726])存在超过2种病因。对于涉及尿动力学结果和临床症状的研究,逼尿肌反射亢进伴收缩功能受损(DHIC)、逼尿肌活动低下(DU)和逼尿肌无收缩(AcD)患者的比例分别为0.7%、5.6%和93.7%。UAB可根据可能的病因机制分为4种类型(特发性、肌源性、神经源性和综合性)。根据尿动力学结果和症状,UAB可分为3种类型(DU、AcD和DHIC)。UAB的分类可为未来研究提供合理依据。