疑似慢性前列腺炎的青年男性伴下尿路症状患者的尿动力学分析

The clinical use of urodynamic studies in the young men with lower urinary tract symptoms

目的探讨尿动力学检查在疑似慢性前列腺炎的青年男性伴下尿路症状(LUTS)患者,评价中的临床应用价值。方法我们回顾性分析了85例18～40岁的临床疑似慢性前列腺炎的青年男性伴LUTS患者的尿动力学检查资料。排除有糖尿病史、神经源性疾病、泌尿系统外伤、手术史或急性尿路感染的患者。所有患者均接受多通道的尿动力学检查。对检查前后的诊断进行比较。结果 85例患者平均年龄为(27.3±4.3)岁;76.5%(65/85例)有储尿期症状,而68.2%(58/85例)有排尿期症状。72.9%(62/85例)例患者出现异常尿动力学检查结果,包括膀胱顺应性降低21.2%(18/85例)例、逼尿肌过度活动25.9%(22/85例)例、逼尿肌-外括约肌协同失调15.3%(13/85例)、膀胱出口梗阻31.8%(27/85例)例和逼尿肌活动低下/无收缩17.6%(15/85例)例。结论临床疑似慢性前列腺炎的青年男性伴LUTS患者的流行病学病因多种多样。临床诊断和治疗常依靠经验,并不准确。尿动力学检查在评价临床疑似慢性前列腺炎的青年男性伴LUTS患者中具有重要价值。

Objective To evaluate the usefulness of urodynamic study in young men with lower urinary tract symptoms （LUTS） who were diagnosed as chronic prostatitis. Methods We reviewed the urodynamic charts of 85 18 -40 years old men with LUTS diagnosed as chronic prostatitis. Those with neurological diseases, urethral trauma or strictures were excluded. All underwent multichannel urodynamic studies （UDS）. The pre - and post - UDS diagnoses were compared. Results The mean age of the patients was 27.3 ~ 4.3 years. Of the patients, 65/85 （76.5 % ） had storage symptoms and 58/85 （68.5%） had voiding symptoms. Abnormal UDS were noted in 62/85 （72.9%） , including compliance de- crease in 18/85 （21.2%）, detrusor overactivity in 22/85 （25.9%）, detrusor - sphincter dyssynergia in 13/85 （ 15.3% ）, bladder outlet ob- struction in 27/85 （31.8%） and detrusor underactivity/acontractility in 15/85 （ 17.6% ）. Conclusion Although diagnosed as chronic prostati- tis, young men presenting with LUTS have different underlying etiologies. Clinical diagnosis and treatment are often empiric and inaccurate. Urodynamic study is useful in the evaluation of this group of patients as it aids in arriving at an accurate diagnosis and guides treatment therapy.