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影像尿动力学在年轻男性下尿路症状及低尿流率病因诊断中的作用

Role of videourodynamics in the identification of causes of lower urinary tract symptoms and low uroflow in young men.

作者信息

Gupta Naveen Kumar, Gaur Shantanu, Pal Dilip Kumar

机构信息

Department of Urology, IPGME&R and SSKM Hospital, Kolkata, West Bengal, India.

出版信息

Urol Ann. 2022 Oct-Dec;14(4):332-335. doi: 10.4103/ua.ua_79_22. Epub 2022 Sep 7.

Abstract

INTRODUCTION

The etiology of lower urinary tract symptoms (LUTS) is multifactorial with causes attributed either to the dysfunction of the bladder or its outlet. Although the etiologies are well studied in aged men, very limited research trials are available in young men with LUTS. Most of the time young men presenting with chronic irritative or obstructive symptoms are labeled with chronic prostatitis or prostatodynia and are treated empirically. In this study using videourodynamics, we prospectively investigated the etiologies of LUTS and low uroflow in young men.

MATERIALS AND METHODS

Fifty male patients, 18-50 years of age attending the urology outpatient department at a tertiary care center from January 2021 to December 2021 with symptoms suggestive of chronic LUTS and low uroflow (maximum urinary flow rate [Qmax] <15 ml/s at a voided volume >150 ml) were included in the study and underwent multichannel videourodynamic study (VUDS). Clinical characteristics and urodynamic results in different diagnostic groups were tabulated and analyzed. The ≤ 0.05 was considered statistically significant.

RESULTS

Out of 50 enrolled patients, primary bladder neck obstruction was seen in 21 patients (42%), dysfunctional voiding in 14 (28%), impaired detrusor contractility (IDC) in 9 (18%), and benign prostatic obstruction (BPO) was noted in 6 patients (12%). The mean age and size of the prostate of patients with BPO were greater than those in the remaining groups and patients with IDC had lower Qmax and Pdet at Qmax than those in the remaining patients.

CONCLUSION

Chronic LUTS in young men has a variety of underlying etiologies and VUDS in this population is helpful in attaining an accurate diagnosis and thus may guide toward efficient management.

摘要

引言

下尿路症状(LUTS)的病因是多因素的,其原因要么归因于膀胱功能障碍,要么归因于膀胱出口功能障碍。尽管在老年男性中对病因进行了充分研究,但针对患有LUTS的年轻男性的研究试验非常有限。大多数情况下,出现慢性刺激性或梗阻性症状的年轻男性被诊断为慢性前列腺炎或前列腺痛,并接受经验性治疗。在这项使用影像尿动力学的研究中,我们前瞻性地调查了年轻男性LUTS和低尿流率的病因。

材料与方法

纳入了50例年龄在18至50岁之间的男性患者,这些患者于2021年1月至2021年12月在一家三级医疗中心的泌尿外科门诊就诊,具有慢性LUTS和低尿流率的症状(排尿量>150 ml时最大尿流率[Qmax]<15 ml/s),并接受了多通道影像尿动力学研究(VUDS)。将不同诊断组的临床特征和尿动力学结果制成表格并进行分析。P≤0.05被认为具有统计学意义。

结果

在50例纳入的患者中,21例(42%)出现原发性膀胱颈梗阻,14例(28%)出现排尿功能障碍,9例(18%)出现逼尿肌收缩力受损(IDC),6例(12%)出现良性前列腺梗阻(BPO)。BPO患者的平均年龄和前列腺大小大于其他组,IDC患者的Qmax和Qmax时的Pdet低于其他患者。

结论

年轻男性的慢性LUTS有多种潜在病因,该人群的VUDS有助于获得准确诊断,从而可能指导有效管理。

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