Mitta Ankur, Singh Gurpremjit, Kumar Panwar Vikas, Sinha Sanjay, Kumar Mandal Arup
All India Institute of Medical Sciences, Uttarakhand, India.
Apollo Institute of Medical Sciences and Research Hyderabad, Telangana, India.
Urol Res Pract. 2024 Jan;50(1):25-35. doi: 10.5152/tud.2024.23155.
This systematic review was done to critically appraise the various evidence available in the literature for the presenting symptoms, diagnosis, and management modalities for primary bladder neck obstruction diagnosed on invasive urodynamics in young adult men 18-50 years of age.
A search was conducted on PubMed, Embase, and Cochrane Central Register of Controlled Trials databases until July 2022 to find English-language studies relevant to the topic.
A total of 10 studies were included. The estimated difference in International Prostate Symptom Score between baseline and 3 months in the subgroup of medical and surgical treatment was found to be -8.82 and -11.25, respectively (P = .37), and after 12 months, it was found to be -7.69 and -17.70 respectively (P .001). The pooled estimate for the difference in Qmax between baseline and 3 months after medical and surgical treatments in the subgroup was found to be 2.92 and 7.03, respectively (P = .18), and after 12 months, it was found to be 4.54 and 7.74, respectively (P .001). The pooled estimate of the difference in post-void residue before and after 3 months of medical and surgical treatments in a subgroup was found to be -31.15 and -70, respectively (P .001), and after 12 months, it was found to be -31.49 and -156.00, respectively (P .001). Quality of life scores improved in both subgroups.
The alpha-blockers are effective in managing primary bladder neck obstruction in the short term, while bladder neck incision is preferred for better longterm outcomes.
本系统评价旨在严格评估文献中关于18至50岁成年男性经侵入性尿动力学诊断的原发性膀胱颈梗阻的症状表现、诊断及治疗方式的各类证据。
截至2022年7月，在PubMed、Embase和Cochrane对照试验中央注册库数据库中进行检索，以查找与该主题相关的英文研究。
共纳入10项研究。在内科和外科治疗亚组中，基线与3个月时国际前列腺症状评分的估计差异分别为-8.82和-11.25（P = 0.37），12个月后分别为-7.69和-17.70（P<0.001）。在内科和外科治疗亚组中，基线与治疗3个月后最大尿流率差异的合并估计值分别为2.92和7.03（P = 0.18），12个月后分别为4.54和7.74（P<0.001）。在内科和外科治疗亚组中，治疗3个月前后残余尿量差异的合并估计值分别为-31.15和-70（P<0.001），12个月后分别为-31.49和-156.00（P<0.001）。两个亚组的生活质量评分均有所改善。
α受体阻滞剂在短期内对原发性膀胱颈梗阻有效，而膀胱颈切开术则更有利于获得更好的长期疗效。
