Griffiths D
Urodynamics and Northern Alberta Continence Service, Misericordia Community Hospital & Health Centre and University of Alberta, Edmonton, Alta, Canada.
Eur Urol. 1998;34 Suppl 1:13-5. doi: 10.1159/000052268.
The term unstable bladder was introduced as a description of an observation not implying pathology. In some patients, special provocative maneuvers may be needed to demonstrate it. It is variable from one test to another. It is observed in some healthy volunteers. Therefore, detrusor instability observed during urodynamic testing is not a medical condition and may not necessarily be clinically relevant. In an individual patient the clinical relevance of the observation must be judged in relation to symptoms and signs of bladder dysfunction. In the field of female incontinence there is general agreement that, statistically, the pre-operative observation of detrusor instability implies poorer results of anti-incontinence surgery. However, some incontinent patients with detrusor instability are improved by surgery. Consequently, different authors draw different conclusions about the clinical relevance of detrusor instability, but no author considers that detrusor instability is an absolute contraindication to surgery for stress incontinence.
“不稳定膀胱”一词最初用于描述一种观察结果，并非意味着存在病理学问题。在某些患者中，可能需要特殊的激发性操作来证实这一情况。每次检查的结果可能有所不同。在一些健康志愿者中也可观察到这种情况。因此，尿动力学检查中观察到的逼尿肌不稳定并非一种疾病状态，也不一定具有临床相关性。对于个体患者，必须结合膀胱功能障碍的症状和体征来判断这一观察结果的临床相关性。在女性尿失禁领域，普遍认为从统计学角度来看，术前观察到逼尿肌不稳定意味着抗尿失禁手术的效果较差。然而，一些存在逼尿肌不稳定的尿失禁患者术后症状有所改善。因此，不同的作者对逼尿肌不稳定的临床相关性得出了不同的结论，但没有作者认为逼尿肌不稳定是压力性尿失禁手术的绝对禁忌证。
