Huang Ting-Xuan, Lo Tsia-Shu, Tseng Hsiao-Jung, Lin Yi-Hao, Liang Ching-Chung, Hsieh Wu-Chiao
Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, 5, Fu-Hsin Street, Kwei-shan, Tao-Yuan City, Taiwan, 333, Republic of China.
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan, Republic of China.
Int Urogynecol J. 2023 Apr;34(4):867-875. doi: 10.1007/s00192-022-05274-7. Epub 2022 Jun 25.
The primary objective of this study is to determine the prevalence of overactive bladder (OAB) and detrusor overactivity (DO) in female patients who were referred for urodynamic study (UDS) because of lower urinary tract symptoms (LUTS). The secondary objective is to determine the subjective and objective differences between female OAB patients with and without DO.
All female patients who underwent UDS for LUTS between June 2016 and September 2019 were retrospectively reviewed. Personal history, medical history, physical examination, and validated questionnaires were collected. One-hour pad test and multichannel urodynamic study was performed. All statistical analyses were conducted by SAS 9.4. P-value < 0.05 was considered statistically significant.
A total of 4184 female patients underwent UDS because of LUTS between June 2016 and September 2019; 1524 patients were analyzed for OAB or DO. The occurrence of OAB was 36.4%. The overall incidence of DO in OAB patients was 15.5%; 9.5% of all patients had DO findings on UDS, and 4.6% were incidental findings. There were significant differences among mean age, parity, ICIQ-UI SF, OABSS, POPDI-6, and all UDS parameters (except for maximal urethral pressure and pressure transmission ratio) between patients with and without DO. In patients with DO, there were no significant differences among age, parity, and BMI with or without OAB symptoms. However, there were significant differences among mean OABSS, ICIQ-UI SF, UDI-6, POPDI-6, IIQ-7, and pad test.
Patients with DO are associated with older age, increased parity, greater urine leakage, and worse storage and micturition functions on UDS. Combinations of subjective and objective measurements are better predictive models for OAB patients.
本研究的主要目的是确定因下尿路症状（LUTS）而接受尿动力学检查（UDS）的女性患者中膀胱过度活动症（OAB）和逼尿肌过度活动（DO）的患病率。次要目的是确定有DO和无DO的女性OAB患者之间的主观和客观差异。
回顾性分析2016年6月至2019年9月期间因LUTS接受UDS的所有女性患者。收集个人史、病史、体格检查和经过验证的问卷。进行了1小时的尿垫试验和多通道尿动力学检查。所有统计分析均使用SAS 9.4进行。P值<0.05被认为具有统计学意义。
2016年6月至2019年9月期间，共有4184名女性患者因LUTS接受了UDS；对1524名患者进行了OAB或DO分析。OAB的发生率为36.4%。OAB患者中DO的总体发生率为15.5%；所有患者中有9.5%在UDS上有DO表现，4.6%为偶然发现。有DO和无DO的患者在平均年龄、产次、ICIQ-UI SF、OABSS、POPDI-6以及所有UDS参数（除最大尿道压力和压力传递率外）之间存在显著差异。在有DO的患者中，有或无OAB症状的患者在年龄、产次和BMI方面无显著差异。然而，在平均OABSS、ICIQ-UI SF、UDI-6、POPDI-6、IIQ-7和尿垫试验之间存在显著差异。
DO患者与年龄较大、产次增加、尿失禁增多以及UDS上储存和排尿功能较差有关。主观和客观测量相结合是OAB患者更好的预测模型。
