Reynard J, Lim C, Abrams P
Bristol Urological Institute, Southmead Hospital, United Kingdom.
Urology. 1996 Apr;47(4):491-6. doi: 10.1016/S0090-4295(99)80483-X.
To determine the relationship between the symptom of intermittency, objective evidence of intermittency on uroflow traces, benign prostatic enlargement, and bladder outlet obstruction (BOO) in men with lower urinary tract symptoms (LUTS).
The prevalence of the symptom of intermittency was determined from a symptom questionnaire in 165 men presenting with LUTS. Objective evidence of intermittency during voiding was assessed from uroflow traces, and prostate volume was measured by transrectal ultrasound. Combined pressure-flow studies were performed to determine the presence or absence of BOO.
There was relatively poor agreement between the symptom of intermittency and objective evidence of its presence. Of the 35 patients who reported intermittency most or all of the time, 21 showed no objective evidence of intermittency on uroflowmetry. The symptom of intermittency was not significantly related to the presence of BOO (P = 0.42) and the group-specific urethral resistance factor (URA) did not differ significantly (P = 0.87) between those men who complained of intermittency and those who did not (median URA, 35 versus 32 cm H2O). However, objective evidence of intermittency on uroflow traces was significantly related to BOO (P = 0.016), and those patients with objective evidence of intermittency had higher URA values (median, 43 versus 32 cm H2O). Objective evidence of intermittency had a specificity of 98% and positive predictive value of 92% for the presence of BOO. Neither the symptom of intermittency nor objective evidence of its presence was significantly related to prostate size.
Although the symptom of intermittency does not seem to be related to BOO or prostate size, objective evidence of intermittency on flow curve traces is specific for outflow obstruction, and as such its presence could potentially be of value in the assessment of men with lower urinary tract symptoms.
确定下尿路症状（LUTS）男性患者间歇性症状、尿流曲线间歇性的客观证据、良性前列腺增生及膀胱出口梗阻（BOO）之间的关系。
通过症状问卷确定165例LUTS男性患者间歇性症状的患病率。从尿流曲线评估排尿期间间歇性的客观证据，经直肠超声测量前列腺体积。进行联合压力-流率研究以确定是否存在BOO。
间歇性症状与其存在的客观证据之间的一致性相对较差。在35例报告大部分或全部时间存在间歇性的患者中，21例在尿流率测定中未显示间歇性的客观证据。间歇性症状与BOO的存在无显著相关性（P = 0.42），抱怨间歇性的男性与未抱怨者之间的组特异性尿道阻力因子（URA）无显著差异（P = 0.87）（URA中位数，35对32 cm H2O）。然而，尿流曲线间歇性的客观证据与BOO显著相关（P = 0.016），有间歇性客观证据的患者URA值更高（中位数，43对32 cm H2O）。间歇性的客观证据对BOO存在的特异性为98%，阳性预测值为92%。间歇性症状及其存在的客观证据均与前列腺大小无显著相关性。
尽管间歇性症状似乎与BOO或前列腺大小无关，但尿流曲线间歇性的客观证据对流出道梗阻具有特异性，因此其存在可能在评估下尿路症状男性患者时具有价值。
