32例慢性前列腺炎患者的尿流动力学分析

The urodynamics study in 32 patients with chronic prostatitis

目的 总结慢性前列腺炎患者可能存在的下尿路症状 ,并结合尿流动力学分析各类症状出现的深层次原因。方法 对 32例慢性前列腺炎患者的尿流率、膀胱压力容积、压力 流率、前列腺压和肌电图进行综合性回顾分析 ,并就慢性细菌性和非细菌性前列腺炎组的尿流动力学变化作了比较。结果 40 6 %的患者存在不稳定性膀胱 ,34 4%的患者有逼尿肌反射亢进 ,46 9%的患者有膀胱出口处梗阻 ,另有 6 8 7%的患者存在逼尿肌 外括约肌协同失调 ;而慢性细菌性和非细菌性前列腺炎组的尿流动力学差异并无显著性。结论 慢性前列腺炎患者出现不同程度的下尿路症状可能与前列腺或盆腔内局部因素诱发的不稳定性膀胱、逼尿肌反射亢进、膀胱出口处梗阻和逼尿肌 外括约肌协同失调有关。认识并解除这些相关因素有助于提高慢性前列腺炎的综合疗效。

ObjectiveTo evaluate the dysfunction of the lower urethral tract of patient with chronic prostatitis(CP) by analysing urodynamic profile.MethodsOur retrospective study was based on 32 patients wi th CP in urology clinics. The clnical data included the measurement of maximum uroflow rate(Qmax), prostatic pressure, filling cystometry, pressureflow(P/Q) study of voiding and electromyography of the external urethral sphincter.ResultsThirteen patients(40.6%) had unstable bladder, 11(34.4% ) had detrusor hyperreflex, 15(46.9%) had bladder outflow obstruction and 22(68 .7%) had detrusorsphincter coordinated disturbances. The urodynamic differenc e between chronic bacterial prostatitis(CBP) and chronic nonbacterial prostatitis (CNBP) wasn't statistically significant.ConclusionThe lower urethral tract symptoms may be associated with unstable bladder, bladder outflow obstruction, detrusor hyperreflex and det rusorsphincter coordinated disturbances induced by prostate or pelvis factors. W e believe that recognizing and eliminating these relative factors will be helpfu l to increase synthetic therapy efficacy on CP.