Chancellor M B, Shenot P J, Rivas D A, Mandel S, Schwartzman R J
Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
J Urol. 1996 Feb;155(2):634-7.
We determined the effect of reflex sympathetic dystrophy on lower urinary tract function.
A total of 20 consecutive patients (16 women and 4 men) with neurologically verified reflex sympathetic dystrophy was referred for voiding symptoms, including urgency, frequency, incontinence and urinary retention. No patient had had voiding symptoms before the initial trauma that induced reflex sympathetic dystrophy. Evaluation included medical history, physical examination, video urodynamic testing and cystoscopy.
Mean patient age was 43.4 +/- 10.2 years (range 28 to 58) and mean duration of urological symptoms was 4.9 +/- 3.6 years (range 1 to 14). Urodynamic study demonstrated a mean cystometric bladder capacity of 417 +/- 182 ml. (range 120 to 700). The urodynamic diagnoses included detrusor hyperreflexia in 8 patients, detrusor areflexia in 8, sensory urgency in 3 and detrusor hyperreflexia with detrusor-external sphincter dyssynergia in 1. In 4 women genuine stress urinary incontinence was also documented urodynamically.
Reflex sympathetic dystrophy may have a profound effect on detrusor and sphincter function.
我们确定了反射性交感神经营养不良对下尿路功能的影响。
共有20例经神经学证实为反射性交感神经营养不良的连续患者（16名女性和4名男性）因排尿症状前来就诊，这些症状包括尿急、尿频、尿失禁和尿潴留。在引发反射性交感神经营养不良的初始创伤之前，没有患者出现过排尿症状。评估包括病史、体格检查、影像尿动力学检查和膀胱镜检查。
患者平均年龄为43.4±10.2岁（范围28至58岁），泌尿系统症状的平均持续时间为4.9±3.6年（范围1至14年）。尿动力学研究显示膀胱容量测定的平均膀胱容量为417±182毫升（范围120至700）。尿动力学诊断包括8例逼尿肌反射亢进、8例逼尿肌无反射、3例感觉性尿急和1例逼尿肌反射亢进伴逼尿肌-外括约肌协同失调。4名女性还通过尿动力学记录了真性压力性尿失禁。
反射性交感神经营养不良可能对逼尿肌和括约肌功能产生深远影响。
