Valentini F A, Marti B G, Robain G, Zimern P E, Nelson P P
Sorbonne université and hôpital Rothschild, 75012 Paris, France.
Sorbonne université and hôpital Rothschild, 75012 Paris, France.
Prog Urol. 2019 Sep;29(11):567-571. doi: 10.1016/j.purol.2019.08.270. Epub 2019 Aug 28.
The aims of the study were to evaluate the reproducibility of bladder voiding efficiency (BVE) between free flow (FF) and intubated flow(IF) in old women, and to search for a relationship of this index with complaint and urodynamic diagnosis.
Urodynamic tracings of non-neurologic women referred for investigation of various lower urinary tract symptoms (LUTS) were analyzed. Urodynamic study included one FF followed by one cystometry and IF. Post void residual volume (PVR) was measured using a Bladder-scan. Exclusion criteria were voided volume<100ml and prolapse of grade>2.
One hundred and ninety women met the study criteria. The mean age was 74±6 years [65-96years]. The main complaint was urinary incontinence: stress (26), urge (53) and mixed (56). Forty-four women had various complaints without incontinence. Overall BVE IF (77.6±25.8) was significantly lower than BVE FF (90.4±15.3) (P<.0001). Age sub-groups stratification led similar results. BVE IF was significantly lower than BVE FF in women with incontinence whatever the cause. Urodynamic diagnosis was posed according to the ICS/IUGA recommendations and 2 sub-groups defined according with involvement of detrusor. BVE IF was significantly lower than BVE FF for detrusor dysfunction, except for detrusor overactivity.
In this large cohort of old non-neurologic women studied urodynamically for a variety of LUTS, BVE is higher when evaluated from a FF whatever age and for complaint of urinary incontinence. In addition, a low BVE value from an IF may suggest a detrusor dysfunction.
本研究旨在评估老年女性自由流（FF）和插管流（IF）之间膀胱排尿效率（BVE）的可重复性，并探寻该指标与症状及尿动力学诊断之间的关系。
对因各种下尿路症状（LUTS）前来检查的非神经源性女性的尿动力学记录进行分析。尿动力学研究包括一次FF，随后进行一次膀胱测压和IF。使用膀胱扫描仪测量排尿后残余尿量（PVR）。排除标准为排尿量<100ml和脱垂分级>2级。
190名女性符合研究标准。平均年龄为74±6岁[65 - 96岁]。主要症状为尿失禁：压力性（26例）、急迫性（53例）和混合性（56例）。44名女性有各种症状但无尿失禁。总体而言，IF时的BVE（77.6±25.8）显著低于FF时的BVE（90.4±15.3）（P<.0001）。年龄亚组分层得出了类似结果。无论病因如何，有尿失禁的女性中IF时的BVE显著低于FF时的BVE。根据国际尿控学会/国际妇科泌尿学会的建议进行尿动力学诊断，并根据逼尿肌受累情况定义了2个亚组。除逼尿肌过度活动外，逼尿肌功能障碍时IF时的BVE显著低于FF时的BVE。
在这一大群因各种LUTS接受尿动力学研究的老年非神经源性女性中，无论年龄大小以及有无尿失禁症状，从FF评估时BVE更高。此外，IF时BVE值低可能提示逼尿肌功能障碍。
4级。
