Radomski S B, Herschorn S, Naglie G
Department of Surgery, Toronto Hospital, University of Toronto, Canada.
J Urol. 1995 Mar;153(3 Pt 1):685-8.
Multiple parameters were examined preoperatively to determine if any could predict successful voiding after prostatectomy in male patients who present in acute urinary retention due to benign prostatic hypertrophy. A total of 50 men 50 to 85 years old (mean age 69.5 years) who presented with this clinical picture was investigated with multichannel urodynamic studies, and completed the American Urological Association (AUA) symptom score for benign prostatic hypertrophy preoperatively and postoperatively. All patients underwent prostatectomy. Mean retention volume was 1,172 cc (range 500 to 2,100). Mean preoperative and postoperative AUA symptom scores were 15.5 and 5.0, respectively. At 3 months postoperatively 45 patients (90%) were able to void without catheterization. At 16.6 months 5 patients still required clean intermittent catheterization to empty the bladder. Postoperatively, there was a statistically significant improvement in AUA symptom score, opening voiding pressure and peak flow rate. The AUA symptom score was not predictive of either impending acute retention or normal voiding after prostatectomy. In our patients no preoperative parameters were statistically different between those voiding and those on clean intermittent catheterization. However, poor sensation, large retention volumes, lack of instability and no voluntary detrusor contractions were more common in the nonvoiding men.
术前检查了多个参数，以确定是否有任何参数可以预测因良性前列腺增生导致急性尿潴留的男性患者前列腺切除术后能否成功排尿。共有50名年龄在50至85岁（平均年龄69.5岁）、出现这种临床表现的男性接受了多通道尿动力学研究，并完成了术前和术后美国泌尿外科学会（AUA）良性前列腺增生症状评分。所有患者均接受了前列腺切除术。平均潴留尿量为1172毫升（范围为500至2100毫升）。术前和术后AUA症状评分的平均值分别为15.5和5.0。术后3个月时，45名患者（90%）能够自主排尿而无需导尿。在16.6个月时，有5名患者仍需要清洁间歇性导尿来排空膀胱。术后，AUA症状评分、初始排尿压力和最大尿流率有统计学上的显著改善。AUA症状评分不能预测前列腺切除术后即将发生的急性尿潴留或正常排尿情况。在我们的患者中，排尿患者和接受清洁间歇性导尿患者的术前参数在统计学上没有差异。然而，感觉减退、潴留尿量多、缺乏不稳定性以及无逼尿肌自主收缩在不能排尿的男性中更为常见。
