Incontinence and detrusor dysfunction associated with pelvic organ prolapse: clinical value of preoperative urodynamic evaluation
Incontinence and detrusor dysfunction associated with pelvic organ prolapse: clinical value of preoperative urodynamic evaluation
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DOI：
10.1007/s00192-009-0954-2
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发表时间：
2009-11-01
影响因子：
1.8
通讯作者：
Takeda, Masayuki
中科院分区：
文献类型：
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作者：
Araki, Isao;Haneda, Yaburu;Takeda, Masayuki
我们探讨了骨盆器官脱垂(POP)手术修复术后尿路问题与术前尿动力学表现之间的关系。术前行咳嗽负荷试验和尿动力学检查，包括压力-流率研究，并进行脱垂复位。术后评估包括尿流率、排尿后残留物和问卷症状评估。简单充盈的咳嗽负荷试验足以诊断隐性压力性尿失禁(SUI)。逼尿肌过度活动的存在是术后紧迫症和急迫性尿失禁持续的良好预测指标。术后残留物(PVR)显著增加，但通常在1个月内恢复。逼尿肌收缩力差是预测大型PVR发生的最佳指标。术前尿动力学评估SUI和逼尿肌功能有助于预测POP患者术后尿路状况。其成本效益仍有待检验。
We examined how preoperative urodynamic findings are related to the urinary problems following surgical repair of pelvic organ prolapse (POP).The clinical records of 87 women who underwent surgery for POP were reviewed retrospectively. Preoperatively, cough stress test and urodynamic testing, including pressure-flow study, were performed with prolapse reduction. Postoperative evaluation included uroflowmetry, postvoid residuals, and symptom assessment using questionnaires.A cough stress test with simple filling was sufficient for diagnosis of occult stress urinary incontinence (SUI). The presence of detrusor overactivity was a good predictor of postoperative persistence of urgency and urge urinary incontinence. Postvoid residuals (PVR) largely increased immediately after surgery, but usually recovered within 1 month. Poor detrusor contractility was the best predictor of large PVR occurrence.Preoperative urodynamic evaluation of SUI and detrusor function was useful for predicting postoperative urinary conditions in POP patients. Its cost-effectiveness remains to be examined.