老年男性排尿障碍的临床病因及尿流动力学分析及意义

The clinical pathogenesis and urodynamics analysis of urination dysfunction in aged male

目的:探讨老年男性排尿障碍的临床病因和尿流动力学检测的临床意义。方法:对老年男性排尿障碍患者304例,通过完整的病史资料和尿动力学结果进行临床病因诊断及尿动力学分析。结果:304例患者中,前列腺增生症患者186例(61%),其它男性泌尿生殖系统疾病21例(7%),非男性泌尿生殖系统疾病77例(25%)。尿流动力学诊断:膀胱出口梗阻132例(43%),逼尿肌不稳定119例(39%),逼尿肌顺应性降低187例(61%),逼尿肌无力/受损77例(25%),逼尿肌-括约肌协同失调38例(12%)。结论:男性老年排尿障碍的病因,有多系统、多种疾病原因,尿流动力学检查能有助于排尿障碍的进一步认识。临床病因与尿流动力学表现结合分析,才能对老年男性排尿障碍患者有较全面、准确的诊断,从而为良好治疗提供基础。

Objective： To explore the clinical pathogenisis of urination dysfunction in aged males and evaluate the bladder and urethra function by urodynamics studies. Methods： Clinical etiological diagnosis and urodynamic studies were performed in 304 aged male patients with urination dysfunction. Results： Among the entire 304 patients, 186 （61%）patients bad benign prostatic hyperplasia. 21 （7%） patients had other male genitourinary system diseases. 77 （25%）patients had no male genitourinary system diseases. Urodynamic studies diagnosed： 132（43% ）patients had bladder outlet obstruction; 119（39%）patients had detrusor instability; 187（61%）patients had detrusor muscle with poor compliance ; 77 （ 25% ）patients had detrusor muscle weakness ; 38 （ 12% ）patients had detrusor-external sphincter dyssynergia. Conclusion： Multisystem and multi-species diseases can cause urination dysfunction in aged males. Urodynamic studies is efficacious for the cognition of the bladder and urethra dysfunction. Clinical etiological diagnosis combined with urodynamie studies can make the diagnosis of urination dvsfunction in aged males more precise.