Ozawa H, Nagai A, Akiyama H, Ichikawa T, Akiyama M, Ono N, Oeda T, Kumon H, Ohmori H
Department of Urology, Okayama University Medical School.
Nihon Hinyokika Gakkai Zasshi. 1997 Oct;88(10):874-9. doi: 10.5980/jpnjurol1989.88.874.
The influence of rectal contractions on urination was examined using multichannel urodynamic study.
We reviewed a total of 246 consecutive urodynamic studies. Each study consisted of a uroflow measurement and multi-channel urodynamic study, evaluating total vesical pressure, abdominal (rectal) pressure, subtracted detrusor pressure and perianal electromyography. Rectal contractions were defined as periodic fluctuations over 5 cmH2O in abdominal pressure detected by a rectal balloon catheter. No relationship of these contractions with cough and breathing was observed.
Of the 246 patients, 17 (6.9%) had a positive study for rectal contractions. The patients, who had positive rectal contractions, averaged 70-year-old were older than negative subjects averaged 62-year-old. In multichannel urodynamics, the flow rate was significantly decreased, and electromyographic activity was increased at the moment of each rectal contractions.
The rectal contractions are not artifactual and may be regarded as one of causes responsible for urinary difficulty in the elderly.
采用多通道尿动力学研究来检测直肠收缩对排尿的影响。
我们回顾了总共246例连续的尿动力学研究。每项研究包括尿流率测量和多通道尿动力学研究,评估膀胱总压力、腹(直肠)压力、逼尿肌减去压力和肛周肌电图。直肠收缩被定义为通过直肠气囊导管检测到的腹压超过5 cmH2O的周期性波动。未观察到这些收缩与咳嗽和呼吸之间的关系。
在246例患者中,17例(6.9%)直肠收缩研究呈阳性。直肠收缩阳性的患者平均年龄为70岁,比直肠收缩阴性的受试者平均年龄62岁要大。在多通道尿动力学中,每次直肠收缩时流速显著降低,肌电图活动增加。
直肠收缩并非人为造成的,可能被视为老年人排尿困难的原因之一。