Urodynamic change in patients with pelvic surgery

“根治性前列腺切除术后尿失禁”在术后3个月和12个月分别持续45%和85%的患者。尿失禁的恢复与术后早期（术后3个月）尿道闭锁压力的改善有关。平均而言)和膀胱顺应性的增加。术后尿道去神经超敏感提示手术过程中α -肾上腺素能系统的神经损伤。Mainz型原位膀胱置换术后16个月，在平均夜间排尿1.8次的情况下，80%的患者尿失禁恢复。尿失禁恢复期患者尿袋测相收缩幅度较低，尿道压力谱测最大尿道闭合压力较高，外尿道括约肌肌电图动作电位频率增加较明显，反映了新膀胱容量和相收缩的变化。直肠癌根治性手术患者的尿动力学研究表明，保留盆腔神经的患者下尿路功能明显更好。术后6个月，保留盆腔神经和未保留盆腔神经的患者的尿流率和残差的正常化率分别为100%和31%。在直肠癌根治性手术后持续排尿功能障碍超过12个月的患者中，逼尿肌不稳定、膀胱去神经支配超敏分别占56%、68%、67%和78%，提示膀胱和尿道功能障碍都是导致排尿失败的原因。“根治性经尿道前列腺切除术”是一种改良的经尿道括约肌切开术，被证明是一种有效的治疗选择，可以减少残留尿，从而在不影响尿控制的情况下取消间歇性自我导尿。少

'Post-radical prostatectomy incontinence' persisted in 45% and 85% of the patients at 3 and 12 months after the operation, respectively. The restoration of continence was as sociated with an improvement in urethral closing pressre in early postoperative poriod (3 months postop. in averrage) and an increase in vesical compliance later on. Postoperative urethral denervation supersensitivity suggests some neurological injury of alpha adrenergic system in the operative procedure.Uninary in continence recovered in 80% of the patients with Mainz type orthotopic bladder substitution at 16 months postoperatively under an averrage of 1.8 times of nocternal urination. In patients who recovered in continence lower amplitude of phasic contraction in pouchmetry, higher maxmal urethral closing pressure in urethral pressure profilometry and more prominent in crease in frequency of action potentials in external urethral sphicter electromyography in response to neobladder capacity and phasic contractio … More n were demonstrated compared to the patients with persistent incontinence.Urodynamic study in the patients with radical surgery for rectal cancer demonstrated the significantly better-reserved 1ower urinary tract function in patients with pelvic nerve preserved. Rate of normalization defined from urinary flow rate and residuals was 100% vs. 31% at 6 months postoperatively in patients with preserved vs. non-preserved pelvic nerve.Of patients with persisted voiding dysfunction for more than 12 months after radical surgery for rectal cancer, detrusor instability, vesical denervation supersensitivity were noted in 56%, 68%, 67% and 78%, respectively, indicating both vesical and urethral dysfunction contribute to voiding failure. 'Radical trasurethral resection of prostate', a modified transurethral sphincterotomy, was demonstrared to be effective treatment option that could reduce residual urine and consequently yield withdrawals of inttermitent self-catheterization without compromising urinary control in these patients. Less