Urodynamic change in patients with pelvic surgery

在术后3个月和12个月，分别有45%和85%的患者持续存在“根治性尿道切除术后尿失禁”。术后早期（术后3个月）尿道闭合压的改善与尿道功能的恢复有关。术后尿道失神经超敏反应提示手术过程中α肾上腺素能系统有一定程度的神经损伤，术后16个月平均排尿1.8次，尿失禁恢复率80%。在恢复期，膀胱测压时相性收缩幅度更低，尿道压力轮廓测定时最大尿道闭合压更高，外尿道括约肌肌电图对新膀胱容量和相性收缩反应的动作电位频率增加更明显的患者， ...更多信息 直肠癌根治术后尿动力学检查显示，保留盆神经的患者保留了较好的泌尿系统功能。术后6个月尿流率和残余尿量恢复正常率分别为100%和31%，直肠癌根治术后排尿功能持续障碍超过12个月的患者中，逼尿肌不稳定和膀胱去神经超敏分别为56%、68%、67%和78%。表明膀胱和尿道功能障碍均导致排尿失败。经尿道前列腺根治性切除术是一种改良的经尿道括约肌切开术，被证明是有效的治疗选择，可以减少残余尿，从而在不影响排尿控制的情况下撤回间歇性自我导尿。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