慢性前列腺炎/慢性盆腔疼痛综合征病人的尿动力学特点及其临床意义

Urodynamic study of chronic prostatitis/chronic pelvic pain syndrome and its clinical significance

目的探讨尿动力学(UDS)在慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)疾病诊断中的应用价值。方法 2015年1月~2019年4月就诊的CP/CPPS病人204例,分析其尿动力学检查结果,包括自由尿流率、充盈期膀胱压力容积、排尿期压力流率测定。结果 204例病人中,最大尿流率(14.3±6.4) ml/s(3.8~62.5 ml/s),自由尿流率排尿量(339.6±126.3)ml(91.2~801.2ml),<300ml者80例(39.2%),>500 ml者23例(11.3%),尿流率曲线形态为正常钟形92例(45.1%),低平曲线96例(47.1%),波浪形16例(7.8%),膀胱残余尿者>50 ml者13例(6.4%)。膀胱敏感性增高61例(29.9%),逼尿肌无抑制性收缩26例(12.7%),膀胱容量减少24例(11.8%),膀胱逼尿肌收缩力降低130例(63.7%),膀胱逼尿肌无力6例(2.9%),膀胱出口梗阻14例(6.9%),UDS未发现异常者44例(21.6%)。结论 UDS检查可以明确CP/CPPS病人存在的特定下尿路功能障碍类型,进而采取针对性的治疗。

Objective To explore the value of urodynamics(UDS)in the diagnosis of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS).Methods We retrospectively analyzed the urodynamic data of 204 patients diagnosed as CP/CPPS from January 2015 to April 2019.The results of urodynamic examination were analyzed,including free uroflowmetry,filling cystometry,and pressure-flow study.Results A total of 204 men were included.The mean Qmax was(14.3±6.4)ml/s,ranging 3.8 to 62.5 ml/s.The mean voided volume(Vv)was(339.6±126.3)ml,ranging 91.2 to 801.2 ml.Vv<300 ml was found in 80 cases(39.2%),and Vv>500 ml in 23(11.3%).The flow rate curve pattern of normal bell-shape demonstrated in 92 cases(45.1%),low flat curve pattern in 96(47.1%),wavy curve in 16(7.8%),post void residual(PVR)>50 ml in 13(6.4%).Urodynamic studies demonstrated increased sensation of bladder in 61 of cases(29.9%),detrusor over-activity in 26(12.7%),small cystometric capacity in 24(11.8%),weak detrusor in 130(63.7%),acontractile detrusor 6(2.9%),bladder outlet obstruction in 14(6.9%),and normal UDS in 44(21.6%).Conclusions UDS examination can identify specific types of lower urinary tract dysfunction in patients with CP/CPPS,and then take targeted treatment.