无神经功能障碍老年男性逼尿肌活动低下的临床特征

Clinical features of detrusor underactivity in elderly men without neurological disorders.

作者信息

Kiba Keisuke, Akashi Yasunori, Yamamoto Yutaka, Hirayama Akihide, Fujimoto Kiyohide, Uemura Hirotsugu

机构信息

Department of Urology, Kindai University Nara Hospital, Ikoma, Japan.

Department of Urology, Nara Medical University, Kashihara, Japan.

出版信息

Low Urin Tract Symptoms. 2022 May;14(3):193-198. doi: 10.1111/luts.12424. Epub 2022 Jan 29.

DOI:10.1111/luts.12424

PMID:35092360

Abstract

OBJECTIVES

To investigate the clinical features of detrusor underactivity (DU) in elderly men without neurological disorders.

METHODS

A total of 336 men aged ≥50 years without neurogenic disorders who underwent pressure flow studies and who had DU or bladder outlet obstruction (BOO) were reviewed retrospectively. According to the bladder contractility index (BCI) and the BOO index (BOOI), the subjects were classified into the following three groups: (a) pure DU group, BCI < 100 and BOOI < 40; (b) DU + BOO group, BCI < 100 and BOOI ≥ 40; and (c) pure BOO group, BCI ≥ 100 and BOOI ≥ 40. Subjective and objective parameters were compared among the three groups, and the predictors for pure DU were evaluated by multivariate analysis.

RESULTS

Of the 336 patients, 205 who met the study criteria were included in the analysis: 63 (30.7%) with pure DU, 48 (23.4%) with DU + BOO, and 94 (45.9%) with pure BOO. The proportion of the pure DU group increased with increasing age. Prostate volume was the lowest in the pure DU group. Frequency, urgency on the International Prostate Symptom Score (IPSS), and the IPSS storage subscore were the lowest in the pure DU group. Multivariate analysis showed that age (odds ratio [OR] 1.114 [95% CI, 1.032-1.203], P = .005), prostate volume (OR 0.968 [95% CI, 0.949-0.987], P = .001), and urgency (OR 0.623 [95% CI, 0.431-0.900], P = .012) were predictors of pure DU.

CONCLUSION

Older age, smaller prostate volume, and less urgency may be clinical features of pure DU.

摘要

目的

研究无神经功能障碍的老年男性逼尿肌活动低下（DU）的临床特征。

方法

回顾性分析336例年龄≥50岁、无神经源性疾病且接受了压力流研究、存在DU或膀胱出口梗阻（BOO）的男性患者。根据膀胱收缩指数（BCI）和BOO指数（BOOI），将受试者分为以下三组：（a）单纯DU组，BCI＜100且BOOI＜40；（b）DU+BOO组，BCI＜100且BOOI≥40；（c）单纯BOO组，BCI≥100且BOOI≥40。比较三组的主观和客观参数，并通过多因素分析评估单纯DU的预测因素。

结果

336例患者中，205例符合研究标准并纳入分析：单纯DU组63例（30.7%），DU+BOO组48例（23.4%），单纯BOO组94例（45.9%）。单纯DU组的比例随年龄增加而升高。单纯DU组的前列腺体积最小。单纯DU组的排尿频率、国际前列腺症状评分（IPSS）中的尿急症状及IPSS储尿期分项评分最低。多因素分析显示，年龄（比值比[OR]1.114[95%可信区间（CI），1.032-1.203]，P=0.005）、前列腺体积（OR 0.968[95%CI，0.949-0.987]，P=0.001）和尿急症状（OR 0.623[95%CI，0.431-0.900]，P=0.012）是单纯DU的预测因素。