Tawada T, Sakakura T, Watanabe H, Noguchi Y, Washida H
Department of Urology, Nagoya City Johsai Hospital.
Nihon Hinyokika Gakkai Zasshi. 1993 May;84(5):879-83. doi: 10.5980/jpnjurol1989.84.879.
We examined pressure-flow test results in 28 male patients with micturition disturbance in whom it is difficult to determine whether bladder outlet obstruction or impaired detrusor contractility is the cause. One reason that some patients do not improve after prostatectomy is that detrusor contractility was not estimated before preoperatively. The degree of infravesical obstruction and of detrusor function were assessed by the method of Griffiths' diagram (maximum flow rate versus corresponding detrusor pressure). Three patients showed infravesical obstruction, 11 equivocal obstruction, and 14 no obstruction. No patients showed strong detrusor function, 14 normal function, and 14 weak function. Eleven patients underwent TU-procedure. Two patients with normal detrusor function and infravesical obstruction showed good postoperative improvement of uroflowmetry results, but 4 patients with weak detrusor function and no infravesical obstruction showed no improvement. Preoperative assessment of the degree of infravesical obstruction and of detrusor function by pressure-flow testing is therefore considered useful. We emphasize that preoperative evaluation of detrusor function is an important aspect of treatment of male micturition disturbance.
我们检查了28例存在排尿障碍的男性患者的压力-流率测试结果,这些患者难以确定膀胱出口梗阻或逼尿肌收缩功能受损究竟哪个是病因。一些患者前列腺切除术后未改善的一个原因是术前未评估逼尿肌收缩功能。采用格里菲斯图表法(最大尿流率与相应逼尿肌压力)评估膀胱下梗阻程度和逼尿肌功能。3例患者存在膀胱下梗阻,11例梗阻情况不明确,14例无梗阻。无患者表现出逼尿肌功能强,14例功能正常,14例功能弱。11例患者接受了经尿道前列腺切除术(TU手术)。2例逼尿肌功能正常且存在膀胱下梗阻的患者术后尿流率结果改善良好,但4例逼尿肌功能弱且无膀胱下梗阻的患者无改善。因此,通过压力-流率测试对膀胱下梗阻程度和逼尿肌功能进行术前评估被认为是有用的。我们强调,术前评估逼尿肌功能是男性排尿障碍治疗的一个重要方面。