Signs and Symptoms of Detrusor Underactivity: An Analysis of Clinical Presentation and Urodynamic Tests From a Large Group of Patients Undergoing Pressure Flow Studies
Signs and Symptoms of Detrusor Underactivity: An Analysis of Clinical Presentation and Urodynamic Tests From a Large Group of Patients Undergoing Pressure Flow Studies
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DOI：
10.1016/j.eururo.2015.08.014
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发表时间：
2016-02-01
期刊：
影响因子：
23.4
通讯作者：
Abrams, Paul
中科院分区：
文献类型：
--
作者：
Gammie, Andrew;Kaper, Mathilde;Abrams, Paul
背景资料：逼尿肌活动不足（DU）的临床诊断受到有创压力流量研究（PFS）的需要以及缺乏相关体征和症状知识的阻碍。这导致了缺乏认识的DU和膀胱活动不足，并假设症状总是由于膀胱出口梗阻（BOO）.Objective：调查的体征和症状记录在一个大型尿动力学数据库的患者谁满足诊断DU，BOO，和正常，以确定与DU相关的临床特征。设计，设置，和参与者：从28282例成人PFS记录的数据库中，将1788例患者分为：（1）DU无BOO患者;（2）BOO无DU患者;（3）PFS正常患者。DU患者报告的尿流减少和/或中断、犹豫、膀胱排空不全的感觉，与PFS正常的患者相比，可触及膀胱，感觉缺失和/或降低。其他差异，发现男性与DU和BOO之间，与DU和正常的PFS之间的女性。结论：有迹象和症状，可以区分DU患者与正常PFS患者，并进一步区分DU和BOO，这是传统的侵入性诊断。这是第一步，以更好地了解DU患者的临床表现，与最近膀胱活动不足的工作定义是一致的，并证明进一步探索的迹象和症状的DU.Patient摘要：逼尿肌活动不足的临床诊断受到阻碍的需要结合侵入性尿动力学缺乏相关的体征和症状的知识。这项研究表明，有迹象和症状，可以区分男性和女性患者DU与正常尿动力学研究或BOO患者。(C)2015年欧洲泌尿外科协会。Elsevier B. V.出版，保留所有权利。
Background: The clinical diagnosis of detrusor underactivity (DU) is hampered by the need for invasive pressure flow studies (PFS) in combination with a lack of knowledge of the associated signs and symptoms. This has contributed to a lack of awareness of DU and underactive bladder, and to the assumption that symptoms are always due to bladder outlet obstruction (BOO).Objective: To investigate the signs and symptoms recorded in a large urodynamic database of patients who met the diagnoses of DU, BOO, and normal, to identify the clinical features associated with DU.Design, setting, and participants: From the database of 28 282 adult PFS records, 1788 patients were classified into: (1) those with DU without BOO; (2) those with BOO without DU; and (3) those with normal PFS.Results: Patients with DU reported a statistically significantly higher occurrence of decreased and/or interrupted urinary stream, hesitancy, feeling of incomplete bladder emptying, palpable bladder, and absent and/or decreased sensation compared with patients with normal PFS. Other differences were found between men with DU and BOO, and between women with DU and normal PFS.Conclusions: There are signs and symptoms that can distinguish DU patients from patients with normal PFS and further distinguish between DU and BOO, which is traditionally invasively diagnosed. This is a first step to better understand the clinical presentation of DU patients, is consistent with the recent underactive bladder working definition, and justifies further exploration of the signs and symptoms of DU.Patient summary: The clinical diagnosis of detrusor underactivity is hampered by the need for invasive urodynamics in combination with a lack of knowledge of the associated signs and symptoms. This study has shown that there are signs and symptoms that can distinguish men and women patients with DU from patients with either normal urodynamic studies or with BOO. (C) 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.