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在逼尿肌活动低下并伴有逼尿肌过度活动的患者中,有哪些附加的体征和症状?

What are the additional signs and symptoms in patients with detrusor underactivity and coexisting detrusor overactivity?

机构信息

Bristol Urological Institute, Southmead Hospital, Bristol, UK.

Astellas Pharma Europe BV., Leiden, South Holland, The Netherlands.

出版信息

Neurourol Urodyn. 2018 Sep;37(7):2220-2225. doi: 10.1002/nau.23565. Epub 2018 Apr 10.

Abstract

AIMS

This study aimed to determine what difference the inclusion of patients with coexisting detrusor overactivity (DO) makes to the signs and symptoms of patients with detrusor underactivity (DU).

METHODS

A total of 250 male and 435 female urodynamic tests were analyzed retrospectively. Signs and symptoms which showed a statistically significant difference between DU without DO and DU with DO were identified.

RESULTS

Males with DO in addition to DU had higher age and number of daily micturitions, and were more likely to report urgency with or without urgency incontinence than males with DU without DO. They also had lower volumes for first desire to void, volume voided, and post void residual urine, lower abdominal pressure at Q and were less likely to report a history of retention or reduced bladder filling sensation than males with DU without DO. Females with DO in addition to DU had higher age and BMI, and were more likely to report urgency incontinence, higher day and night pad usage, constipation and have reduced anal tone than females with DU without DO. They also had lower volumes for first desire to void, volume voided, and post void residual urine, and lower abdominal pressure at Q than females who had DU without DO.

CONCLUSIONS

There are differences in signs and symptoms between patients who have DU without DO, compared to patients having DU with DO. This understanding will help future studies investigating treatment options for DU patients.

摘要

目的

本研究旨在确定合并逼尿肌过度活动(DO)的患者的存在对逼尿肌活动低下(DU)患者的症状和体征有何影响。

方法

回顾性分析了 250 例男性和 435 例女性尿动力学检查。确定了在无 DO 的 DU 和有 DO 的 DU 之间表现出统计学显著差异的症状和体征。

结果

患有 DO 合并 DU 的男性年龄较大,每日排尿次数较多,更有可能报告尿急伴或不伴急迫性尿失禁,而患有单纯 DU 的男性则较少。他们的首次排尿意愿量、排尿量和残余尿量也较低,Q 点的腹内压较低,且较不可能报告有潴留或膀胱充盈感降低的病史,而患有单纯 DU 的男性则较少。患有 DO 合并 DU 的女性年龄较大,BMI 较高,更有可能报告急迫性尿失禁,白天和夜间使用尿垫更多,便秘,肛门张力降低,而患有单纯 DU 的女性则较少。他们的首次排尿意愿量、排尿量和残余尿量也较低,Q 点的腹内压也较低。

结论

无 DO 的 DU 患者与有 DO 的 DU 患者在症状和体征方面存在差异。这种理解将有助于未来研究 DU 患者的治疗选择。

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