终末滴沥在男性下尿路症状中的意义。

The significance of terminal dribbling in men with lower urinary tract symptoms.

作者信息

Reynard J M, Lim C, Peters T J, Abrams P

机构信息

Bristol Urological Institute, Southmead Hospital, UK.

出版信息

Br J Urol. 1996 May;77(5):705-10. doi: 10.1046/j.1464-410x.1996.95615.x.

DOI:10.1046/j.1464-410x.1996.95615.x

PMID:8689115

Abstract

OBJECTIVE

To determine the relationship between the symptom of terminal dribbling, objective evidence of terminal dribbling on recordings of uroflow, benign prostatic enlargement (BPE) and bladder outlet obstruction (BOO) in men with lower urinary tract symptoms (LUTS).

PATIENTS AND METHODS

The prevalence of the symptom of terminal dribbling was determined from a symptom questionnaire completed by 165 men presenting with LUTS. Objective evidence of terminal dribbling during voiding was assessed from uroflow recordings and prostate volume was measured by transrectal ultrasonography. Combined pressure-flow studies were performed to determine the presence or absence of BOO.

RESULTS

There was relatively poor agreement between the symptom of terminal dribbling and objective evidence of its presence; 48% of the patients who reported terminal dribbling most or all of the time showed no objective evidence of terminal dribbling on uroflowmetry. The symptom of terminal dribbling was not significantly related to the presence of BOO (P = 0.74) and the group-specific urethral resistance factor (URA) did not differ significantly (P = 0.79) between those men who complained of terminal dribbling and those who did not (median URA 33 and 31 cmH2O, respectively). However, objective evidence of terminal dribbling on uroflow traces was significantly related to BOO (P < 0.001) and those patients with objective evidence of terminal dribbling had higher values of URA (median 39 compared with 28 cmH2O). Objective terminal dribbling had a specificity of 92% and positive predictive value of 88% for the presence of BOO. Neither the symptom of terminal dribbling nor objective evidence of its presence were significantly related to prostatic enlargement.

CONCLUSION

While the symptom of terminal dribbling is probably not related to BOO or prostatic enlargement, objective evidence of terminal dribbling on flow curve recording is specific for BOO and as such, its presence could potentially be of value in the assessment of men with LUTS.

摘要

目的

确定下尿路症状（LUTS）男性患者中终末滴沥症状、尿流记录中终末滴沥的客观证据、良性前列腺增生（BPE）和膀胱出口梗阻（BOO）之间的关系。

患者与方法

通过对165例有LUTS的男性患者完成的症状问卷来确定终末滴沥症状的患病率。通过尿流记录评估排尿期间终末滴沥的客观证据，并通过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。

结果

终末滴沥症状与其存在的客观证据之间的一致性相对较差；48%报告大部分或全部时间有终末滴沥的患者在尿流率测定中未显示终末滴沥的客观证据。终末滴沥症状与BOO的存在无显著相关性（P = 0.74），抱怨终末滴沥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 = 0.79）（URA中位数分别为33和31 cmH₂O）。然而，尿流曲线上终末滴沥的客观证据与BOO显著相关（P < 0.001），有终末滴沥客观证据的患者URA值更高（中位数为39 cmH₂O，而无终末滴沥者为28 cmH₂O）。客观终末滴沥对BOO存在的特异性为92%，阳性预测值为88%。终末滴沥症状及其存在的客观证据均与前列腺增生无显著相关性。