Dalhousie University, Halifax, Nova Scotia, Canada.
Translational Health Sciences, Bristol Medical School, Bristol, UK.
Neurourol Urodyn. 2018 Aug;37(S6):S25-S31. doi: 10.1002/nau.23758.
To introduce basic concepts and definitions in the International Continence Society (ICS) Standardisation of Terminology in adult Neurogenic Lower Urinary Tract Dysfunction (NLUTD).
Fundamental terminology in the ICS Standardisation of Terminology of Adult NLUTD was identified and summarized.
NLUTD is often associated with impairment of cognitive, motor, sensory, and/or autonomic functions. Lesions are categorized into suprapontine, pontine/suprasacral spinal, sacral spinal, cauda equina/peripheral nerve, or mixed lesions. People affected with neurological disease are also at risk of the conditions seen in the general population, such as benign prostate enlargement. Symptoms of NLUTD include alterations in bladder or urethral sensation and incontinence. Loss of urine can result from incontinence, involuntary passing of urine and factors that impair toilet use, incorporating problems such as impaired cognition urinary incontinence, impaired mobility urinary incontinence, and voiding dysregulation. Signs may be discerned by physical examination and recording of a frequency volume chart or bladder diary. Urodynamic observations during filling cystometry may include altered sensations, neurogenic detrusor overactivity, and reduced bladder compliance. During pressure flow studies, there may be detrusor underactivity or bladder outlet obstruction (BOO). BOO may be caused by various forms poorly co-ordinated muscle activity in the bladder outlet. Symptoms, signs, and urodynamic observations may be useful in diagnosing the presence and specific location of neurological impairment.
The review provides a succinct summary of symptoms, signs, and urodynamic observations as set out in the ICS Standard on Adult NLUTD.
介绍国际尿控协会(ICS)成人神经源性下尿路功能障碍(NLUTD)术语标准化中的基本概念和定义。
确定并总结了 ICS 成人 NLUTD 术语标准化中的基本术语。
NLUTD 通常与认知、运动、感觉和/或自主功能障碍有关。病变分为桥脑以上、桥脑/骶髓、骶髓、马尾/周围神经或混合病变。患有神经疾病的人也有患一般人群中所见疾病的风险,如良性前列腺增生。NLUTD 的症状包括膀胱或尿道感觉改变和失禁。尿失禁可导致尿液流失,包括无意识排尿和影响使用厕所的因素,包括认知障碍性尿失禁、行动障碍性尿失禁和排尿调节障碍等问题。通过体格检查和记录频率-体积图表或膀胱日记可以发现体征。充盈性膀胱测压期间的尿动力学观察可能包括感觉改变、神经源性逼尿肌过度活动和膀胱顺应性降低。在压力-流研究中,可能存在逼尿肌活动不足或膀胱出口梗阻(BOO)。BOO 可能由各种形式的膀胱出口肌肉活动不协调引起。症状、体征和尿动力学观察可有助于诊断神经功能损伤的存在和特定部位。
本文综述简要总结了 ICS 成人 NLUTD 标准中规定的症状、体征和尿动力学观察。