Qin Yan, Wang Fei, Zhang Chaohua, Wu Liyang
Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Department of Urology, Guangxi Hospital Division of the First Affiliated Hospital, Sun Yat-Sen University, Nanning, China.
Low Urin Tract Symptoms. 2025 May;17(3):e70013. doi: 10.1111/luts.70013.
Rarely have studies focused on the utilization of urethral pressure profile (UPP) in bladder neck obstruction (BNO). This study aimed to evaluate the parameters of UPP in urodynamic testing (UDS) using air-charged catheters (ACC) and to investigate the value of UPP as a diagnostic tool for female BNO.
We retrospectively collected records of 165 female patients with lower urinary tract symptoms (LUTS) who received UDS at our center from September 2020 to September 2022. The whole patient group was divided into BNO group (n = 92) and non-BNO group (n = 73). The urodynamic data were evaluated.
The UPP includes urethral pressures at the bladder neck (b-UP) and urethral sphincter (s-UP). The b-UP was higher in the BNO group than in the non-BNO group [104.50 (40.50) cmH2O vs. 58.00 (33.50) cmH2O, p < 0.001]. According to multivariable logistic regression analysis, b-UP and bladder voiding efficiency (BVE) were independently associated with BNO. The area under the curve (AUC) of the b-UP had the best value for predicting BNO [AUC: 0.878, sensitivity: 88.04%, specificity: 76.71%, 95% confidence interval (CI): 0.819-0.924]; its cut-off value was 72 cmH2O. Meanwhile, Cohen's kappa was 0.65 (95% CI: 0.537-0.770), indicating that UPP as a diagnostic tool was highly consistent with the video-urodynamic study (VUDS).
UPP by air-charged urodynamic catheters can show the pressure of the bladder neck, with predictive value for identifying BNO in women. The predictive method based on UPP and pressure-flow study (PFS) without fluoroscopy will improve the diagnostic accuracy of BNO, which could help urologists in making better clinical decisions.
很少有研究关注膀胱颈梗阻（BNO）中尿道压力分布（UPP）的应用。本研究旨在评估使用充气导管（ACC）进行尿动力学检测（UDS）时UPP的参数，并探讨UPP作为女性BNO诊断工具的价值。
我们回顾性收集了2020年9月至2022年9月在本中心接受UDS的165例有下尿路症状（LUTS）的女性患者的记录。将整个患者组分为BNO组（n = 92）和非BNO组（n = 73）。对尿动力学数据进行评估。
UPP包括膀胱颈处尿道压力（b-UP）和尿道括约肌处尿道压力（s-UP）。BNO组的b-UP高于非BNO组[104.50（40.50）cmH₂O对58.00（33.50）cmH₂O，p < 0.001]。根据多变量逻辑回归分析，b-UP和膀胱排尿效率（BVE）与BNO独立相关。b-UP的曲线下面积（AUC）对预测BNO具有最佳价值[AUC：0.878，敏感性：88.04%，特异性：76.71%，95%置信区间（CI）：0.819 - 0.924]；其截断值为72 cmH₂O。同时，科恩kappa系数为0.65（95% CI：0.537 - 0.770），表明UPP作为诊断工具与影像尿动力学检查（VUDS）高度一致。
充气式尿动力学导管的UPP可显示膀胱颈压力，对女性BNO的识别具有预测价值。基于UPP和压力 - 流率研究（PFS）且无需荧光透视的预测方法将提高BNO的诊断准确性，这有助于泌尿外科医生做出更好的临床决策。
