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残余尿容积能否预测多发性硬化症患者下尿路症状的恶化?

Does Post-Void Residual Volume Predict Worsening Urological Symptoms in Patients with Multiple Sclerosis?

机构信息

University of Michigan, Ann Arbor, Michigan.

University of Michigan, Ann Arbor, Michigan.

出版信息

J Urol. 2018 Oct;200(4):868-874. doi: 10.1016/j.juro.2018.04.068. Epub 2018 Apr 24.

Abstract

PURPOSE

Our goal was to examine how post-void residual urine volume relates to urinary symptoms in patients with multiple sclerosis.

MATERIALS AND METHODS

We retrospectively reviewed the records of patients with multiple sclerosis who had lower urinary tract symptoms and presented to a tertiary neurourology clinic. Patients for whom post-void residual volume was recorded at the initial urological assessment were included in our analysis. Results of the AUA (American Urological Association) SI (Symptom Index) and the M-ISI (Michigan Incontinence Symptom Index) completed at this visit were analyzed to assess the severity of lower urinary tract symptoms and incontinence. A chart review was performed to obtain information on demographics and documented urinary tract infections.

RESULTS

Between 2014 and 2017, 110 patients diagnosed with multiple sclerosis underwent post-void residual volume measurement at our clinic. Average post-void residual volume was 123.4 cc (range 0 to 650 cc). The mean AUA symptom score was 19.1 with an average bother score of 4.1. Analysis of post-void residual volume as a continuous variable did not show an association between increasing post-void residual volume and an increasing AUA SI or bother score (p = 0.53 and 0.44, respectively). When evaluated by post-void residual volume tertile, no relationship was found between post-void residual volume, and the AUA SI and the M-ISI (p = 0.54 and 0.57, respectively). No correlation was also found between increasing post-void residual volume and a recent history of recurrent urinary tract infections (p = 0.27).

CONCLUSIONS

Post-void residual volume was not associated with worsening obstructive lower urinary tract symptoms as assessed by the AUA SI, worsening incontinence as measured by the M-ISI score or an increased risk of recurrent urinary tract infections in select patients with multiple sclerosis and lower urinary tract symptoms.

摘要

目的

本研究旨在探讨多发性硬化症患者的残余尿体积与下尿路症状之间的关系。

材料与方法

我们回顾性分析了在一家三级神经泌尿科就诊的伴有下尿路症状的多发性硬化症患者的病历。本研究纳入了在首次泌尿科评估时记录了残余尿体积的患者。分析了患者在此次就诊时完成的美国泌尿协会症状指数(AUA SI)和密歇根失禁症状指数(M-ISI)的结果,以评估下尿路症状和尿失禁的严重程度。通过病历回顾获取患者的人口统计学资料和尿路感染的记录信息。

结果

2014 年至 2017 年间,在我们的诊所共有 110 例多发性硬化症患者接受了残余尿体积测量。残余尿平均体积为 123.4cc(范围 0 至 650cc)。平均 AUA 症状评分为 19.1,平均困扰评分为 4.1。将残余尿体积作为连续变量进行分析时,未发现残余尿体积与 AUA SI 或困扰评分的增加之间存在相关性(p 值分别为 0.53 和 0.44)。当按残余尿体积三分位法评估时,也未发现残余尿体积与 AUA SI 和 M-ISI 之间存在相关性(p 值分别为 0.54 和 0.57)。残余尿体积的增加与复发性尿路感染史之间也无相关性(p = 0.27)。

结论

在伴有下尿路症状的多发性硬化症患者中,残余尿体积与 AUA SI 评估的梗阻性下尿路症状恶化、M-ISI 评分评估的尿失禁恶化或尿路感染复发风险增加无关。

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