Porru D, Dore A, Usai M, Campus G, Delisa A, Scarpa R M, Usai E
Dipartimento di Scienze Chirurgiche e Trapianti d'Organo, Università di Cagliari, Italia.
Urol Int. 1994;53(1):30-3. doi: 10.1159/000282627.
The study included 18 men, submitted to urodynamic investigation 9-18 months after cystoprostatectomy for bladder cancer and bladder substitution with a detubularized ileal segment as described by Studer-Zingg. Sixteen patients were continent by day and 3 were incontinent during the night so as to require the use of a condom catheter. The residual urine was over 100 ml in 3 patients, while it was low or absent in the remainder. Micturition was performed by straining, and maximal flow rates were normal, although the pattern was intermittent. The incidence of nocturnal incontinence was 55.5%. Measurement of the urethral pressure profile revealed a shortened functional length, and low pressure was found in 3 patients, with a maximum urethral closure pressure < 45 cm H2O. During extramural ambulatory urodynamic monitoring, pressure values in the neobladder usually ranged below 20 cm H2O and exceeded 34 cm H2O in only 2 patients who complained of daytime and nocturnal incontinence. The urodynamic features of the neobladder in patients who underwent radical cystoprostatectomy and bladder replacement with a detubularized ileal segment indicate low pressure at high-level filling.
该研究纳入了18名男性，他们在接受膀胱癌膀胱前列腺切除术后9至18个月接受了尿动力学检查，并按照Studer-Zingg的描述，用去管化回肠段进行膀胱替代。16名患者白天控尿，3名患者夜间失禁，因此需要使用阴茎套导管。3名患者残余尿量超过100毫升，其余患者残余尿量较少或无残余尿。排尿通过用力进行，最大尿流率正常，尽管排尿模式是间歇性的。夜间失禁发生率为55.5%。尿道压力分布图测量显示功能长度缩短，3名患者尿道压力低，最大尿道闭合压<45厘米水柱。在壁外动态尿动力学监测期间，新膀胱的压力值通常低于20厘米水柱，只有2名抱怨白天和夜间失禁的患者超过34厘米水柱。接受根治性膀胱前列腺切除术并用去管化回肠段进行膀胱替代的患者，其新膀胱的尿动力学特征表明在高容量充盈时压力较低。
