Yoshida Masaki, Sekido Naritoshi, Matsukawa Yoshihisa, Yono Makoto, Yamaguchi Osamu
Department of Urology, National Center for Geriatrics and Gerontology, Obu, Japan.
Department of Urology, Toho University Medical Center Ohashi Hospital, Tokyo, Japan.
Low Urin Tract Symptoms. 2021 Jan;13(1):13-16. doi: 10.1111/luts.12356. Epub 2020 Oct 7.
Detrusor underactivity (DU) is a common bladder dysfunction that causes lower urinary tract symptoms (LUTS) in both men and women. Currently DU can only be diagnosed by an invasive urodynamic test. Underactive bladder (UAB) is the symptom-based correlate of DU, as is the case with overactive bladder (OAB) and detrusor overactivity (DO). The International Continence Society (ICS) consensus group has recently proposed a working definition of UAB as a symptom syndrome suggestive of DU. However, a symptom complex of UAB is shared by LUTS attributable to bladder outlet obstruction (BOO). Thus, UAB is not specific for DU, leading to difficulties in determining a therapeutic target (DU or BOO) in the initial management of UAB. Under these circumstances, a consensus group was formed under the auspices of the Japanese Continence Society (JCS) and diagnostic criteria were produced to potentially identify patients likely to have DU, without a pressure/flow study-based diagnosis. Certain symptoms and several noninvasive test parameters have been reported as clinical predictors of DU, and were suggested to discriminate DU from BOO. Of these predictive factors, the more commonly used parameters were used to develop clinical diagnostic criteria for DU. This article presents the clinical diagnostic criteria for DU proposed by the JCS consensus group and aims to summarize the background discussion by the group.
逼尿肌活动低下（DU）是一种常见的膀胱功能障碍，可导致男性和女性出现下尿路症状（LUTS）。目前，DU只能通过侵入性尿动力学检查来诊断。膀胱活动低下（UAB）是DU基于症状的对应情况，就像膀胱过度活动症（OAB）和逼尿肌过度活动（DO）一样。国际尿控协会（ICS）共识小组最近提出了UAB的工作定义，即一种提示DU的症状综合征。然而，膀胱出口梗阻（BOO）所致的LUTS也存在UAB的症状复合体。因此，UAB并非DU所特有，这导致在UAB的初始管理中难以确定治疗靶点（DU或BOO）。在这种情况下，在日本尿控协会（JCS）的支持下成立了一个共识小组，并制定了诊断标准，以潜在地识别可能患有DU的患者，而无需基于压力/流量研究的诊断。某些症状和几个非侵入性测试参数已被报道为DU的临床预测指标，并被建议用于区分DU和BOO。在这些预测因素中，更常用的参数被用于制定DU的临床诊断标准。本文介绍了JCS共识小组提出的DU临床诊断标准，并旨在总结该小组的背景讨论。
