Detrusor pressures in urodynamic studies during voiding in women
Detrusor pressures in urodynamic studies during voiding in women
复制标题
女性排尿期间尿动力学研究中的逼尿肌压力
DOI：
10.1007/s00192-016-3203-5
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发表时间：
2017
期刊：
影响因子：
1.8
通讯作者：
Kira S,Mitsui T,Kobayashi H,Haneda Y,Sawada N,Takeda M
中科院分区：
文献类型：
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作者：
Ihara Tatsuya;Mitsui Takahiko;Nakamura Yuki;Kanda Mie;Tsuchiya Sachiko;Kira Satoru;Nakagomi Hiroshi;Sawada Norifumi;Hirayama Yuri;Shibata Keisuke;Shigetomi Eiji;Shinozaki Yoichi;Yoshiyama Mitsuharu;Nakao Atsuhito;Takeda Masayuki;Koizumi Schuichi;Kira S,Yoshiyama M,Tsuchiya S,Shigetomi E,Miyamoto T,Nakagomi H,Shibata K,Mochizuki T,Takeda M,Koizumi S;Kira S,Mitsui T,Kobayashi H,Haneda Y,Sawada N,Takeda M
前言和假设利用尿动力学研究(UDS)研究女性排尿过程中的逼尿肌压力。所有患者都在2010年1月至2014年12月期间接受了UDS。UDS包括充盈膀胱测压、压力流率研究(PFS)、最大尿流率(Qmax)和平均尿流率的尿流率测定仪，以及排空后残余尿流率。自发性逼尿肌收缩的存在被定义为在PFS中指示排尿后逼尿肌压力(PDET)的持续和平稳增加。计算膀胱收缩指数为Pdet at Qmax + 5×Qmax。结果PFS显示23例患者( +组)和34例患者(−组)在排尿过程中无逼尿肌收缩。Pdet+和Pdet−组之间除Pdet在Qmax和BCI时的尿动力学参数外，其余指标均无显著差异。在Pdet− 组中，21例患者排尿时腹压升高(Pabd+组)，13例患者无明显升高(Pabd−组)。Pabd+组和Pabd−组的任何尿动力学参数均无差异。结论根据UDS，女性排尿时可能不需要增加逼尿肌或腹压。本研究提示，包括正常的尿路功能在内的盆底肌肉松弛对女性排尿具有重要意义。
Introduction and hypothesisTo investigate detrusor pressure during voiding in women using urodynamic studies (UDS).MethodsThe study group comprised 57 women with non-neurogenic lower urinary tract symptoms. All patients underwent UDS between January 2010 and December 2014. UDS included filling cystometry, pressure flow study (PFS), uroflowmetry for the maximum flow rate (Qmax) and mean flow rate, and postvoid residuals. Existence of voluntary detrusor contraction was defined as a continuous and smooth increase in detrusor pressure (Pdet) after the instruction to micturate in the PFS. The bladder contractility index (BCI) was calculated asPdet atQmax + 5 ×Qmax. Statistical analyses were performed using the Mann–WhitneyUtest andp< 0.05 was considered statistically significant.ResultsThe PFS showed that 23 patients had detrusor contraction (Pdet+ group) and 34 patients had no detrusor contraction (Pdet− group) during voiding. There were no significant differences in urodynamic parameters between thePdet+ andPdet− groups except inPdet atQmax and BCI. In thePdet− group, 21 patients showed an increase in abdominal pressure during voiding (Pabd+ group), while the other 13 patients did not (Pabd− group). There were no differences in any of the urodynamic parameters between thePabd+ andPabd− groups.ConclusionsBased on UDS, an increase in detrusor or abdominal pressure may not be necessary in micturition in women. The present study suggests that relaxation of pelvic floor muscles including normal urethral function are important for micturition in women.