Kaplan S A, Reis R B
Department of Urology, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
J Urol. 1996 Nov;156(5):1668-72.
Various investigators have reported the lack of specificity of the American Urological Association (AUA) symptom score and its poor correlation with urodynamic parameters. A retrospective study was performed to ascertain the correlation of the AUA symptom score with various urodynamic parameters, including detrusor contraction duration.
The urodynamic records of 120 consecutive patients with moderate (scores 8 to 19) or severe (scores greater than 19) symptoms were retrospectively analyzed to ascertain if the AUA symptom score correlated with the urodynamic parameters of maximum detrusor pressure, detrusor pressure at maximum flow, compliance, involuntary detrusor contractions and, a novel parameter, detrusor contraction duration.
There were 63 men (mean age 59.7 years) and 57 women (mean age 58.8 years). Mean AUA symptom score plus or minus standard deviation was 17.8 +/- 3.7 and 15.4 +/- 2.9, respectively. There was no correlation between any urodynamic parameter and symptoms in women. In men increasing symptoms were associated with worsening urodynamic parameters. The 2 parameters that had the greatest correlation with symptom severity were incidence of involuntary detrusor contractions (r = 0.56, p < 0.006) and detrusor contraction duration (r = 0.61, p < 0.003). Furthermore, increasing incidence of involuntary detrusor contractions was associated with increasing irritative symptoms, while increasing detrusor contraction duration was correlated with increasing obstructive symptoms. Detrusor contraction duration was correlated with symptom severity and urodynamic outlet obstruction in men.
These data demonstrated that the AUA symptom score correlates with certain urodynamic parameters. Furthermore, this correlation occurs in men in contrast to women despite similar AUA symptom scores. In addition, increasing detrusor contraction duration is associated with worsening symptoms and may herald worsening obstruction. Further prospective studies are underway to determine the prognostic value of these urodynamic parameters in altering ultimate outcomes of treatment.
众多研究者报告称，美国泌尿外科学会（AUA）症状评分缺乏特异性，且与尿动力学参数的相关性较差。开展了一项回顾性研究，以确定AUA症状评分与包括逼尿肌收缩持续时间在内的各种尿动力学参数之间的相关性。
回顾性分析了120例连续患者的尿动力学记录，这些患者具有中度（评分8至19分）或重度（评分大于19分）症状，以确定AUA症状评分是否与最大逼尿肌压力、最大尿流率时的逼尿肌压力、顺应性、逼尿肌不自主收缩以及一个新参数——逼尿肌收缩持续时间等尿动力学参数相关。
有63名男性（平均年龄59.7岁）和57名女性（平均年龄58.8岁）。AUA症状评分的平均值加减标准差分别为17.8±3.7和15.4±2.9。女性的任何尿动力学参数与症状之间均无相关性。在男性中，症状加重与尿动力学参数恶化相关。与症状严重程度相关性最大的两个参数是逼尿肌不自主收缩的发生率（r = 0.56，p < 0.006）和逼尿肌收缩持续时间（r = 0.61，p < 0.003）。此外，逼尿肌不自主收缩发生率增加与刺激性症状增加相关，而逼尿肌收缩持续时间增加与梗阻性症状增加相关。逼尿肌收缩持续时间与男性的症状严重程度和尿动力学出口梗阻相关。
这些数据表明，AUA症状评分与某些尿动力学参数相关。此外，尽管AUA症状评分相似，但这种相关性在男性中存在，而在女性中不存在。此外，逼尿肌收缩持续时间增加与症状恶化相关，可能预示着梗阻加重。正在进行进一步的前瞻性研究，以确定这些尿动力学参数在改变最终治疗结果方面的预后价值。
