Dekhtiar Yuriy M, Kostyev Fedir I, Zacheslavsky Oleksandr M, Kuznietsov Dmytro O
Department of Urology and Nephrology, Odessa National Medical University, Odessa, Ukraine.
Urol Ann. 2019 Jan-Mar;11(1):83-86. doi: 10.4103/UA.UA_37_18.
The aims of this study were to determine the frequency and clinical significance of individual urodynamic signs, which revealed on the basis of the results of comprehensive urodynamic examination of patients with the idiopathic overactive bladder (IOAB), to produce definitions of these features, and to describe any necessary remedial action.
To identify the most common features and artifacts, we conducted a combined urodynamic examination of 137 patients with IOAB (105 women and 32 men). Age, comorbidities, and urodynamic parameters were analyzed to determine the association between bladder sensation and contractility.
It was found that most patients suffer from the same type of bladder function impairment, often related to the decrease in the average effective capacity of the bladder, frequent urination, urgency urination, and urgent urinary incontinence events. Imperative nature of urination in patients with IOAB leads to the reduction maximum cystometric capacity in 75.9% of patients, increased bladder sensitivity threshold in 70.8%, detrusor overactivity in 35.8%, change in bladder compliance in 43.1%, and urethral instability in 24.8% of patients.
Decreased ability of the bladder to accumulate and hold the urine under the normal or low intravesical pressure and frequent association of bladder instability with signs of obstructive urination are major peculiarities of the impaired urodynamics of the lower urinary tract in patients with IOAB.
本研究的目的是确定在特发性膀胱过度活动症(IOAB)患者全面尿动力学检查结果基础上所揭示的个体尿动力学体征的频率和临床意义,给出这些特征的定义,并描述任何必要的补救措施。
为了识别最常见的特征和假象,我们对137例IOAB患者(105例女性和32例男性)进行了联合尿动力学检查。分析年龄、合并症和尿动力学参数,以确定膀胱感觉与收缩性之间的关联。
发现大多数患者患有相同类型的膀胱功能损害,通常与膀胱平均有效容量降低、尿频、尿急和急迫性尿失禁事件有关。IOAB患者排尿的紧迫性导致75.9%的患者最大膀胱测压容量降低,70.8%的患者膀胱敏感性阈值升高,35.8%的患者逼尿肌过度活动,43.1%的患者膀胱顺应性改变,24.8%的患者尿道不稳定。
膀胱在正常或低膀胱内压下积聚和储存尿液的能力下降,以及膀胱不稳定与排尿梗阻体征的频繁关联,是IOAB患者下尿路尿动力学受损的主要特点。