Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Department of Urology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2021 Oct 1;84(10):937-941. doi: 10.1097/JCMA.0000000000000593.
Among female patients with lower urinary tract symptoms, detrusor underactivity (DU), and detrusor overactivity-with-detrusor underactivity (DO-DU) are two common diagnoses. Here, we investigated the correlations between bladder wall thickness (BWT) and clinical manifestations of the two diagnoses.
From 2011 to 2016, female patients with DU or DO-DU, diagnosed at our institute, were recruited. We analyzed their urodynamic parameters and collected three questionnaires (IPSS, UDI-6, OABSS). Using transabdominal sonography, the BWT was recorded. DU was defined as follows: maximum free flow rate (Qmax) ≤ 15 cc/s; detrusor pressure at maximum flow (PdetQmax) ≤ 20 cmH2O; bladder capacity > 150 cc. DO-DU was defined as follows: Qmax ≤ 15 cc/s; PdetQmax ≤ 20 cmH2O; bladder capacity ≤ 150 cc. The BWTs of the two groups were compared using the Mann-Whitney U test; the correlations among the BWTs and the results of three questionnaires were analyzed using Spearman's rank correlation coefficient.
Forty-eight female patients with DU and 13 with DO-DU were recruited. Demographic data revealed no differences between the two groups. The mean BWT of the DO-DU patients was significantly larger than that of the DU patients (4.11 vs 3.42 mm; p = 0.001). In the DO-DU group, a high correlation existed between the BWT and some of the UDI-6 items (urgency incontinence: r = 0.831, p = 0.006; incontinence related to activity: r = 0.884, p = 0.002; small amounts of leakage: r = 0.809, p = 0.008). The BWT of the DO-DU patients also exhibited a moderate correlation with the urgency incontinence from the OABSS questionnaire (r = 0.679; p = 0.044). No correlations existed between the BWT of the DU patients and any of the data from the three questionnaires.
The BWT in the DO-DU patients was significantly thicker than that in the DU patients. The DO-DU patients with thicker bladder walls also had higher UDI-6 scores for both urgency and urgency incontinence.
在患有下尿路症状的女性患者中，逼尿肌活动低下（DU）和逼尿肌过度活动伴逼尿肌活动低下（DO-DU）是两种常见的诊断。在这里，我们研究了膀胱壁厚度（BWT）与这两种诊断的临床表现之间的相关性。
2011 年至 2016 年，我们招募了在我院诊断为 DU 或 DO-DU 的女性患者。我们分析了他们的尿动力学参数，并收集了三个问卷（IPSS、UDI-6、OABSS）。使用经腹超声，记录 BWT。DU 的定义如下：最大自由流率（Qmax）≤15cc/s；最大流动时逼尿肌压力（PdetQmax）≤20cmH2O；膀胱容量>150cc。DO-DU 的定义如下：Qmax≤15cc/s；PdetQmax≤20cmH2O；膀胱容量≤150cc。使用曼惠特尼 U 检验比较两组的 BWT；使用斯皮尔曼等级相关系数分析 BWT 与三个问卷结果之间的相关性。
共招募 48 例 DU 女性患者和 13 例 DO-DU 女性患者。两组患者的人口统计学数据无差异。DO-DU 患者的平均 BWT 明显大于 DU 患者（4.11 vs 3.42mm；p=0.001）。在 DO-DU 组中，BWT 与 UDI-6 部分项目高度相关（急迫性尿失禁：r=0.831，p=0.006；活动相关的尿失禁：r=0.884，p=0.002；少量漏尿：r=0.809，p=0.008）。DO-DU 患者的 BWT 与 OABSS 问卷中的急迫性尿失禁也呈中度相关（r=0.679；p=0.044）。DU 患者的 BWT 与三个问卷中的任何数据均无相关性。
DO-DU 患者的 BWT 明显厚于 DU 患者。膀胱壁较厚的 DO-DU 患者的 UDI-6 评分在急迫性和急迫性尿失禁方面也更高。
