Martins José Tadeu Carvalho, Marquini Gisele Vissoci, de Abreu Laura Aparecida Xavier, Bella Zsuzsanna Ilona Katalin de Jármy Di, Sartori Marair Gracio Ferreira
Universidade Federal do Espírito Santo VitóriaES Brazil Universidade Federal do Espírito Santo, Vitória, ES, Brazil.
Universidade Federal de São Paulo Escola Paulista de Medicina São PauloSP Brazil Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Rev Bras Ginecol Obstet. 2025 Jul 15;47. doi: 10.61622/rbgo/2025rbgo52. eCollection 2025.
This study aims to characterize voiding urodynamics parameters suggestive of bladder outlet obstruction (BOO) diagnosis in women with and without symptomatic pelvic organ prolapse (POP).
Cross-sectional research. Patients were selected and clinically evaluated with anamnesis, pelvic organ prolapse quantification system and standard Urodynamic Testing, performed according to International Continence Society and International Urogynecological Association guidelines (noninvasive uroflowmetry, followed by invasive cystometry and a Pressure/Flow Study). Included criteria: women aged 18 to 94 years with and without symptomatic POP and lower urinary tract symptoms . Exclusion criteria: patients who were not clinically feasible, undesirable, or impossible urodynamic test, or patients with urinary tract infection or neurological lower urinary tract dysfunction.
Voiding urodynamics parameters suggestive of BOO diagnosis found in women with POP were: maximum flow rate (Qmax) in the uroflowmetry ≤12mL/s; detrusor pressure at maximum flow (PdetQmax) >20cmH2O. When evaluating the differences between patients with and without POP, it was observed that those who presented some type of pPOP were mean age (y) older (67.6 × 58.9); had higher post-void residue volume (mL) (85.9 × 33.9); higher PdetQmax (cmHO) values (41.3 × 28.5); lower Qmax (mL/s) values on uroflowmetry (8.5 × 20.4), lower maximum cystometric capacity (mL) (325.7 × 381.2), lower bladder compliance (mL/cmH2O) (39.8 × 46.1) and lower Qmax (mL/cmH2O) in the flow/pressure study (8.4 × 18.0) (<0.001).
The voiding urodynamics parameters listed in this study allows the evaluation of variables suggestive of BOO diagnosis in women with and without POP.
本研究旨在确定有症状和无症状盆腔器官脱垂（POP）的女性中提示膀胱出口梗阻（BOO）诊断的排尿尿动力学参数。
横断面研究。根据国际尿失禁学会和国际妇科泌尿协会的指南（非侵入性尿流率测定，随后进行侵入性膀胱测压和压力/流量研究），选择患者并通过病史、盆腔器官脱垂量化系统和标准尿动力学测试进行临床评估。纳入标准：年龄在18至94岁之间、有或无症状性POP及下尿路症状的女性。排除标准：临床上不可行、不理想或无法进行尿动力学测试的患者，或患有尿路感染或神经性下尿路功能障碍的患者。
在有POP的女性中发现提示BOO诊断的排尿尿动力学参数为：尿流率测定中的最大尿流率（Qmax）≤12mL/s；最大尿流时逼尿肌压力（PdetQmax）>20cmH2O。在评估有POP和无POP患者之间的差异时，观察到出现某种类型的pPOP的患者平均年龄（岁）更大（67.6×58.9）；排尿后残余尿量（mL）更高（85.9×33.9）；PdetQmax（cmHO）值更高（41.3×28.5）；尿流率测定中的Qmax（mL/s）值更低（8.5×20.4），最大膀胱测压容量（mL）更低（325.7×381.2），膀胱顺应性（mL/cmH2O）更低（故39.8×46.1），流量/压力研究中的Qmax（mL/cmH2O）更低（8.4×18.0）（<0.001）。
本研究中列出的排尿尿动力学参数可用于评估有和无POP的女性中提示BOO诊断 的变量。
