女性排尿困难71例诊治体会

Diagnosis and Treatment of Female Patients with Dysuria (reports of 71 cases)

目的:探讨女性排尿困难的发病原因及治疗方法。方法:以排尿困难为主诉的女性患者71例,行外阴检查、膀胱尿道镜检查、尿动力学检查包括尿流率、同步膀胱压力容积流率及肛门括约肌肌电图测定,部分患者同步透视下行影像尿动力学检查。结果:膀胱出口梗阻47例(66.2%),非神经原性神经性膀胱20例(28.2%),各项检查正常4例(5.6%),分别给予手术及药物治疗。治疗前后症状评分(IPSS)平均分别为(15.4±2.3)和(7.1±0.9)(P<0.05),平均最大尿流率(MFR)分别为(9.3±5.7)mL/s、(18.5±8.0)mL/s(P<0.05)。结论:根据女性排尿困难的病因,选择相应的治疗措施,是提高疗效的关键。

Objective. To study the etiology and treatment of dysuria in female patients. Methods： Seventy-one female patients complaining of dysuria were examined subsequently with cystourethroscopy and urodynamics after perineal physical examination. All patients received the treatment according to the disease, including surgery, drug and physical treatment. Assessment was performed before and after the therapy using IPSS（international prostate syndrome score）and urodynamics. Results.Forty-seven（66. 2%） patients were diagnosed with bladder outlet obstruction, 20（28.2%）with non-neurogenic neuropathic bladder and 4（5. 6%） without abnormal results. The pre-and post-operative mean IPSS were （ 15.4±2.3） and （7.1±0. 9） （P 〈 0. 05）, respectively. The mean MFR（maximum flow rate） was（9.3±5.7）mL/s and （18.5±8.0）m L/s（P 〈0.05）, respectively. Conclusion：Bladder outlet obstruction is the main cause of dysuria in female. The proper treatments may optimize the therapy effect if adopted according to the different illness.