DETRUSOR-EXTERNAL SPHINCTER DYSSYNERGIA IN MEN WITH MULTIPLE-SCLEROSIS - AN OMINOUS UROLOGIC CONDITION
DETRUSOR-EXTERNAL SPHINCTER DYSSYNERGIA IN MEN WITH MULTIPLE-SCLEROSIS - AN OMINOUS UROLOGIC CONDITION
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DOI：
10.1016/s0022-5347(17)50216-5
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发表时间：
1984-01-01
影响因子：
6.6
通讯作者：
BARBALIAS, GA
中科院分区：
文献类型：
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作者：
BLAIVAS, JG;BARBALIAS, GA
男性（27例）多发性硬化症患者接受尿动力学评价，作为排尿功能障碍前瞻性研究的一部分。18例逼尿肌-外括约肌协同失调患者中，9例出现严重泌尿系统并发症，包括反复发作的尿脓毒症、膀胱输尿管反流和尿石症。9例无协同失调的患者均未发生任何泌尿系统并发症。泌尿系统并发症与逼尿肌-外括约肌协同失调的存在和多发性硬化的严重程度高度相关，但与多发性硬化的持续时间、患者年龄或协同失调的类型无关。虽然没有治疗是没有并发症，似乎无论是抗胆碱能药物加间歇性自我导尿或避孕套导管引流是上级优于留置导管的初步保守治疗。如果保守治疗失败，可能需要外括约肌切开术或尿流改道术。
Men (27) with multiple sclerosis underwent urodynamic evaluation as part of a prospective study of voiding dysfunction. Of 18 patients with detrusor-external sphincter dyssynergia 9 suffered serious urologic complications, including repeated episodes of urosepsis, vesicoureteral reflux and urolithiasis. None of the 9 patients without dyssynergia suffered any urologic complications. Urologic complications were correlated highly to the presence of detrusor-external sphincter dyssynergia and the severity of multiple sclerosis but not to duration of multiple sclerosis, age of the patient or type of dyssynergia. Although no treatment was without complications it appears that either anticholinergics plus intermittent self-catheterization or condom catheter drainage is superior to an indwelling catheter for initial conservative treatment. External sphincterotomy or urinary diversion may be necessary if conservative therapy fails.