前列腺增生患者下尿路症状评估及治疗

Evaluation and Treatment of Lower Urinery-tract Syndrome of Patients with Denign Prostatic Hypertrophy

目的探讨前列腺增生患者下尿路症状的原因及尿动力学检查在治疗方法选择中的意义。方法对162例有下尿路症状的前列腺增生患者进行尿动力学检查,根据检查结果选择治疗方法,并对治疗效果进行分析。结果膀胱出口梗阻和逼尿肌不稳定为主要表现,分别为77.2%(125/162)及64.2%(104/162),膀胱顺应性减低及逼尿肌收缩无力亦有表现。治疗方法包括药物治疗、留置尿管、膀胱穿刺造瘘及前列腺切除。结论前列腺增生患者下尿路症状的主要病因为膀胱出口梗阻及其引起的逼尿肌功能障碍,尿动力学检查可准确区分梗阻与非梗阻,判断逼尿肌功能状态,为合理选择治疗方案提供可靠依据。

Objective To investigate the causes of lower urinery - tract syndrom of patients with benign prostatic hypertrophy, and the role of urodynamic studies in treatment choosing. Methods Urodynamic studies were carried out in 162 patients of benign prostatic hypertrophy with lower urinery-tract syndrom. Suitable treatment were selected according to the result. Results Bladder outflow objection and detrusor instable were main finds, the percentage was 77.2% （125/162） and 64. 2% （ 104/ 162）. Bladder compliance reduce and detrusor weak could also be found. The treatments include drug, urine catheter serva, bladder stoma and prostatic ectomize. Conclusion The main cause of the lower urinery- tract syndrom of benign prostatic hypertrophy is bladder outflow obstruction and the detrusor disfunction due to it. Urodynamic studies can exactly discriminate obstruction and no obstruction, evaluate the function of detrusor, and provide reliable proof for resonable management.