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[混合性尿失禁和特发性急迫性尿失禁女性膀胱过度活动症症状的比较。]

[Comparison of the symptoms of overactive bladder in women with mixed urinary incontinence and idiopathic urge urinary incontinence.].

作者信息

Arribillaga Leandro, Bengió Rubén Guillermo, Ledesma Marta, Montedoro Ariel, Orellana Sergio, Pisano Florencia, Bengió Ruben Hugo

机构信息

Centro Urológico Profesor Bengió. Córdoba. Argentina.

出版信息

Arch Esp Urol. 2018 Jul;71(6):531-536.

Abstract

INTRODUCTION

Various authors argued that the voiding urgency component in mixed urinary incontinence (MUI) is different than urge urinary incontinence (UUI). In this last case they suggest that incontinence in MUI could be overdiagnosed in patients with SUI, misunderstanding the leak as UUI.

OBJETIVES

To evaluate clinical and urodynamic characteristics of patients with MUI and pure UUI.

METHODS

A retrospective study of our urodynamics database was performed evaluating 450 women with MUI and UUI. Patients with neurogenic bladder, fistulae, urethral diverticula, previous urogynecologic surgery, known infravesical obstruction, previous pelvic radiotherapy, urinary tract infection or psychiatric drugs intake. A full clinical history, physical exam, uroflowmetry, filling cystometry and pressure flow study were performed.

RESULTS

There is no difference relative to age, menopause and number of births. The presence of nocturia was bigger in the UUI group (66.4% vs. 46.1%, p 0.0004) the same as increased voiding frequency (53.6% vs. 34.6%, p 0.0006). The presence of urethral hypermobility and SUI in the physical exam was greater than MUI, meanwhile the presence of reduced vaginal trophism was bigger in the UUI group. Differences in sensibility or specificity were not found. The presence of overactive detrusor was 56.4% in pure UUI vs. 33.2% in MUI (p<0.0001). No differences in pressure flow study were found.

CONCLUSIONS

There is a significant difference in the clinical and urodynamic parameters between patients with MUI and pure UUI. The urgency in patients with pure UUI could be related to overactive detrusor. It is probable that many patients with MUI just have pure SUI which could lead to positive effects in the outcomes of anti-incontinence surgery.

摘要

引言

多位作者认为,混合性尿失禁(MUI)中的排尿急迫成分与急迫性尿失禁(UUI)不同。他们指出,在后一种情况下,MUI患者的尿失禁可能在压力性尿失禁(SUI)患者中被过度诊断,将漏尿误解为UUI。

目的

评估MUI和单纯UUI患者的临床及尿动力学特征。

方法

对我们的尿动力学数据库进行回顾性研究,评估450例MUI和UUI患者。排除患有神经源性膀胱、瘘管、尿道憩室、既往有泌尿妇科手术史、已知膀胱颈以下梗阻、既往盆腔放疗史、尿路感染或服用精神类药物的患者。进行了完整的临床病史、体格检查、尿流率测定、充盈性膀胱测压和压力流率研究。

结果

在年龄、绝经状态和生育次数方面无差异。UUI组夜尿症的发生率更高(66.4%对46.1%,p = 0.0004),排尿频率增加的情况也是如此(53.6%对34.6%,p = 0.0006)。体格检查中尿道活动过度和SUI的发生率高于MUI,同时UUI组阴道萎缩的发生率更高。未发现敏感性或特异性方面的差异。单纯UUI患者逼尿肌过度活动的发生率为56.4%,而MUI患者为33.2%(p<0.0001)。压力流率研究未发现差异。

结论

MUI和单纯UUI患者在临床和尿动力学参数方面存在显著差异。单纯UUI患者的急迫性可能与逼尿肌过度活动有关。许多MUI患者可能仅患有单纯的SUI,这可能会对抗尿失禁手术的结果产生积极影响。

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