单纯间歇导尿改善神经源性膀胱并发上尿路扩张积水12例报道

Upper Urinary Tract Dilation Resolved by Only Intermittent Catheterization in Neurogenic Bladder: 12 Cases Report

目的探讨单纯间歇导尿改善神经源性膀胱患者上尿路扩张积水的影像尿动力学适应症。方法回顾性分析2008年1月至2016年6月采用单纯间歇导尿处理的12例神经源性膀胱并发上尿路扩张积水患者的临床资料。结果经系统规律随访,本组患者肾积水均得到缓解或消失。其影像尿动力学共同特点为无逼尿肌过度活动,测压容积>300 ml,储尿期末逼尿肌压力<40cm H2O,无膀胱输尿管返流,排空差,腹压排尿,残余尿>150 ml。结论对于储尿功能尚可,主要表现为排尿障碍的神经源性膀胱并发上尿路扩张积水患者,建议首选间歇导尿。

Objective To investigate the video-urodynamics indication of upper urinary tract dilation secondary to neurogenic bladder that may be resolved only by intermittent catheterization. Methods From January, 2008 to August, 2016, twelve cases of upper urinary dila- tion secondary to neurogenic bladder were treated by intermittent catheterization only. Their clinical data was reviewed. Results The mor- phology and function index of upper urinary tract were improved gradually during the regular follow-ups. The common video-urodynamics characteristics include no detrusor overactivity, no vesicoureteral reflux, cysctometry volume larger than 300 ml and detrusor presser at the capacity lower than 40 cmH20, poor voiding efficiency with residual volume larger than 150 ml. Conclusion For upper urinary tract dilation secondary to neurogenic bladder characterized as passable storage and poor voiding, intermittent catheterization may be enough to resolve the dilation.