Hsiao Sheng-Mou, Wu Pei-Chi, Chang Ting-Chen, Chen Chi-Hau, Lin Ho-Hsiung
Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan.
Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.
Int Neurourol J. 2019 Mar;23(1):69-74. doi: 10.5213/inj.1836212.106. Epub 2019 Mar 31.
To identify factors predicting the presence of overactive bladder syndrome (OAB)-wet, compared with OAB-dry.
Between September 2007 and September 2013, the medical records of 623 women with OAB who completed a 3-day bladder diary and underwent urodynamic studies in a medical center were retrospectively reviewed. OAB-wet was diagnosed in patients who complained of at least one episode of urgency incontinence in the previous month; otherwise, OAB-dry was diagnosed. Multivariable logistic regression analysis was used to predict the presence of OAB-wet.
Age (odds ratio [OR], 1.05; P<0.001), maximal flow rate (Qmax) (OR,1.06; P<0.001), voided volume (OR, 0.996; P=0.001), detrusor pressure at maximal flow rate (PdetQmax) (OR, 1.02; P=0.003), urgency episodes (OR, 1.04; P<0.001) and urodynamic stress incontinence (OR,1.78; P=0.01) were independent predictors for the presence of OAB-wet vs. OAB-dry. If we use bladder contractility index as a variable for multivariable logistic regression analysis, bladder contractility index (OR, 1.012; P<0.001) become an independent predictor for OAB-wet.
A smaller bladder capacity and more frequent urgency episodes were predictors of OAB-wet, and the above findings indicate that OAB-wet and OAB-dry might be a continuum of OAB. Old age, high Qmax, high PdetQmax and urodynamic stress incontinence were also predictors for OAB-wet, and the above results reveal that OAB-wet and OAB-dry have partially different clinical and urodynamic features. Further studies might be performed to elucidate whether different treatment strategies between OAB-dry and OAB-wet can improve treatment efficacy.
确定与无尿失禁的膀胱过度活动症(OAB)相比,预测有尿失禁的膀胱过度活动症(OAB-wet)存在的因素。
回顾性分析2007年9月至2013年9月期间在某医疗中心完成3天膀胱日记并接受尿动力学检查的623例OAB女性患者的病历。在前一个月内主诉至少有一次急迫性尿失禁发作的患者被诊断为OAB-wet;否则,诊断为OAB-dry。采用多变量logistic回归分析预测OAB-wet的存在。
年龄(比值比[OR],1.05;P<0.001)、最大尿流率(Qmax)(OR,1.06;P<0.001)、排尿量(OR,0.996;P=0.001)、最大尿流率时逼尿肌压力(PdetQmax)(OR,1.02;P=0.003)、急迫发作次数(OR,1.04;P<0.001)和尿动力学压力性尿失禁(OR,1.78;P=0.01)是OAB-wet与OAB-dry存在的独立预测因素。如果将膀胱收缩力指数作为多变量logistic回归分析的变量,膀胱收缩力指数(OR,1.012;P<0.001)成为OAB-wet的独立预测因素。
膀胱容量较小和急迫发作更频繁是OAB-wet的预测因素,上述发现表明OAB-wet和OAB-dry可能是OAB的一个连续体。老年、高Qmax、高PdetQmax和尿动力学压力性尿失禁也是OAB-wet的预测因素,上述结果表明OAB-wet和OAB-dry具有部分不同的临床和尿动力学特征。可能需要进一步研究以阐明OAB-dry和OAB-wet之间不同的治疗策略是否能提高治疗效果。