Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan.
Sci Rep. 2019 Dec 11;9(1):18887. doi: 10.1038/s41598-019-55386-2.
To analyze the change of detrusor contractility by investigating urodynamic characteristics with long term follow-up. This study retrospectively reviewed 166 lower urinary tract symptoms patients without bladder outlet obstruction (BOO) and 63 patients with BOO who underwent repeated urodynamic studies at the first time and more than 10 years later. The urodynamic parameters, bladder contractility index (BCI), and BOO index (BOOI) were compared before and after. As time goes by, detrusor pressure at maximum flow rate (PdetQmax) significantly decreased and post-void residual (PVR) volume significantly increased in both men and women. Full sensation, urge sensation, voided volume, and BCI significantly decreased. We also compared men with and without BOO, PdetQmax, maximum flow rate (Qmax), voided volume, and BCI all significantly decreased in both groups without difference. PVR increased greater in men with BOO after >10 years significantly (p = 0.036). Women with detrusor overactivity (DO) under antimuscarinic showed no significant BCI change compared to patients without DO (p = 0.228). Detrusor contractility decreases in men and women after >10 years of follow-up. However, this finding suggests that patients with BOO or DO under adequate medical treatment, detrusor contractility is not aggravated over 10 or more years of follow-up.
通过长期随访分析尿动力学特征来评估逼尿肌收缩力的变化。本研究回顾性分析了 166 例无膀胱出口梗阻(BOO)的下尿路症状患者和 63 例首次和 10 年以上后重复行尿动力学检查的 BOO 患者。比较了两次检查的尿动力学参数、膀胱收缩力指数(BCI)和 BOO 指数(BOOI)。随着时间的推移,男性和女性的最大尿流率时逼尿肌压力(PdetQmax)均显著下降,而剩余尿量(PVR)显著增加。完全感觉、急迫感、排尿量和 BCI 均显著下降。我们还比较了有和无 BOO 的男性患者,两组患者的 PdetQmax、最大尿流率(Qmax)、排尿量和 BCI 均显著下降,且无明显差异。10 年以上后,BOO 男性患者的 PVR 增加更为显著(p = 0.036)。与无逼尿肌过度活动(DO)的患者相比,接受抗胆碱能药物治疗的 DO 女性患者的 BCI 无明显变化(p = 0.228)。10 年以上随访后,男性和女性的逼尿肌收缩力均下降。然而,这一发现表明,接受适当药物治疗的 BOO 或 DO 患者,在 10 年或更长时间的随访中,逼尿肌收缩力不会恶化。