Objective:To investigate the urodynamic study(UDS)patterns,obstruction status,continence status,and their correlations among neurologically intact women with lower urinary tract symptoms(LUTS)through an epidemiologica...Objective:To investigate the urodynamic study(UDS)patterns,obstruction status,continence status,and their correlations among neurologically intact women with lower urinary tract symptoms(LUTS)through an epidemiological and logistic regression analyses.Methods:We retrospectively analyzed the UDS data of 3265 neurologically intact women with LUTS(2002e2014).Five UDS patterns were identified:normo-active detrusor/sphincter(NA,or DSI,detrusor/sphincter intact),idiopathic detrusor overactivity(IDO),idiopathic sphincter overactivity(ISO),IDO+ISO,and detrusor underactivity(DUA).Analyses of UDS pattern distribution and stratification were performed(based on a modification of the European Urological Association-Madersbacher classification system),and their correlations with bladder outlet obstruction(BOO)and stress urinary incontinence(SUI)status were evaluated via logistic regression analysis.Results:NA,IDO,IDO+ISO,ISO,and DUA were noted in 927(28.4%),678(20.8%),320(9.8%),689(21.1%),and 651(19.9%)cases,respectively.Moreover,storage,storage+voiding,and voiding symptoms were noted in 62.4%,21.1%,and 16.5% cases,respectively,whereas BOO and SUI were observed in 12.1%and 29.0%cases,respectively.The risk factors for BOO included NA,IDO,ISO,and IDO+ISO,whereas the protective factors against BOO included storage symptoms,SUI,storage+voiding symptoms,and complaint duration within 1e12 months.NA was the only risk factor for SUI,whereas BOO,storage+voiding symptoms,IDO,and storage symptoms were protective factors for SUI.Conclusion:Five UDS patterns were identified among neurologically intact women with LUTS.Functional abnormalities of the detrusor and/or sphincter were the main causes of LUTS,and were correlated with the BOO or SUI status.Thus,the UDS pattern can provide additional information regarding the risk factors for BOO or SUI status,as compared to symptomatic typing.展开更多
Objective: To explore a myogenic basis of the spontaneous contractions on the rat bladder smooth muscle strip in a detrusor instability (DI) model in vitro, and to study a nerve blocker's cocktail affecting the sp...Objective: To explore a myogenic basis of the spontaneous contractions on the rat bladder smooth muscle strip in a detrusor instability (DI) model in vitro, and to study a nerve blocker's cocktail affecting the spontaneous contractions as well as electrical stimulated contractile response. Methods: DI model rats were made by partial bladder outlet obstruction (BOO) and confirmed by the filling cystome-try. Detrusor strip was dissected from fresh bladder, fixed for an isometric tension trial. The contractions were recorded during electrical stimulation or exposure to some agents. Results: The cocktail diminished the nerve-mediated contractile response effectively in DI preparation. DI's spontaneous contractions remained during the presence of the cocktail with a significant change in its contractile amplitude. Conclusion : With the local nerve-concerned factors abolishment by the cocktail, the DI bladder preparations still have the spontaneous contractions, indicating a myogenic basis from themselves.展开更多
Pressure-flow study(PFS) of micturition is the best method to quantitatively analyse voiding function. It allows us to distinguish voiding lower urinary tract symptoms and low urine flow rate caused by bladder outlet ...Pressure-flow study(PFS) of micturition is the best method to quantitatively analyse voiding function. It allows us to distinguish voiding lower urinary tract symptoms and low urine flow rate caused by bladder outlet obstruction(BOO) from those caused by detrusor underactivity(DU). Voiding dynamics are significantly different in men and women and the established criteria for urodynamic diagnosis in men do not apply to women. Basic principles of voiding mechanics and voiding patterns in asymptomatic women are analyzed. Although attempts have been made to establish a consensus for diagnosis of BOO in women with pressure-flow cutoff, video-urodynamics criteria and nomograms, currently there is no consensus. There is no standard urodynamic test to diagnose and quantify DU in women for which further investigations are needed. Modified projected isovolumetric pressure(to assess detrusor contraction strength) and pressure-flow cutoff criteria have been used. The diagnosis of voiding dysfunction in women is challenging, requiring PFS with very good quality control and often involves integrating clinical and radiographic data to make the final assessment.展开更多
Background Detrusor overactivity （DO） is a known cause of lower urinary tract symptoms and occurs in 50%-75% of benign prostate hyperplasia （BPH） patients. We sought to investigate the clinical and urodynamic fact...Background Detrusor overactivity （DO） is a known cause of lower urinary tract symptoms and occurs in 50%-75% of benign prostate hyperplasia （BPH） patients. We sought to investigate the clinical and urodynamic factors that are associated with the presence of DO in Chinese BPH patients.展开更多
文摘Objective:To investigate the urodynamic study(UDS)patterns,obstruction status,continence status,and their correlations among neurologically intact women with lower urinary tract symptoms(LUTS)through an epidemiological and logistic regression analyses.Methods:We retrospectively analyzed the UDS data of 3265 neurologically intact women with LUTS(2002e2014).Five UDS patterns were identified:normo-active detrusor/sphincter(NA,or DSI,detrusor/sphincter intact),idiopathic detrusor overactivity(IDO),idiopathic sphincter overactivity(ISO),IDO+ISO,and detrusor underactivity(DUA).Analyses of UDS pattern distribution and stratification were performed(based on a modification of the European Urological Association-Madersbacher classification system),and their correlations with bladder outlet obstruction(BOO)and stress urinary incontinence(SUI)status were evaluated via logistic regression analysis.Results:NA,IDO,IDO+ISO,ISO,and DUA were noted in 927(28.4%),678(20.8%),320(9.8%),689(21.1%),and 651(19.9%)cases,respectively.Moreover,storage,storage+voiding,and voiding symptoms were noted in 62.4%,21.1%,and 16.5% cases,respectively,whereas BOO and SUI were observed in 12.1%and 29.0%cases,respectively.The risk factors for BOO included NA,IDO,ISO,and IDO+ISO,whereas the protective factors against BOO included storage symptoms,SUI,storage+voiding symptoms,and complaint duration within 1e12 months.NA was the only risk factor for SUI,whereas BOO,storage+voiding symptoms,IDO,and storage symptoms were protective factors for SUI.Conclusion:Five UDS patterns were identified among neurologically intact women with LUTS.Functional abnormalities of the detrusor and/or sphincter were the main causes of LUTS,and were correlated with the BOO or SUI status.Thus,the UDS pattern can provide additional information regarding the risk factors for BOO or SUI status,as compared to symptomatic typing.
文摘Objective: To explore a myogenic basis of the spontaneous contractions on the rat bladder smooth muscle strip in a detrusor instability (DI) model in vitro, and to study a nerve blocker's cocktail affecting the spontaneous contractions as well as electrical stimulated contractile response. Methods: DI model rats were made by partial bladder outlet obstruction (BOO) and confirmed by the filling cystome-try. Detrusor strip was dissected from fresh bladder, fixed for an isometric tension trial. The contractions were recorded during electrical stimulation or exposure to some agents. Results: The cocktail diminished the nerve-mediated contractile response effectively in DI preparation. DI's spontaneous contractions remained during the presence of the cocktail with a significant change in its contractile amplitude. Conclusion : With the local nerve-concerned factors abolishment by the cocktail, the DI bladder preparations still have the spontaneous contractions, indicating a myogenic basis from themselves.
文摘Pressure-flow study(PFS) of micturition is the best method to quantitatively analyse voiding function. It allows us to distinguish voiding lower urinary tract symptoms and low urine flow rate caused by bladder outlet obstruction(BOO) from those caused by detrusor underactivity(DU). Voiding dynamics are significantly different in men and women and the established criteria for urodynamic diagnosis in men do not apply to women. Basic principles of voiding mechanics and voiding patterns in asymptomatic women are analyzed. Although attempts have been made to establish a consensus for diagnosis of BOO in women with pressure-flow cutoff, video-urodynamics criteria and nomograms, currently there is no consensus. There is no standard urodynamic test to diagnose and quantify DU in women for which further investigations are needed. Modified projected isovolumetric pressure(to assess detrusor contraction strength) and pressure-flow cutoff criteria have been used. The diagnosis of voiding dysfunction in women is challenging, requiring PFS with very good quality control and often involves integrating clinical and radiographic data to make the final assessment.
文摘Background Detrusor overactivity （DO） is a known cause of lower urinary tract symptoms and occurs in 50%-75% of benign prostate hyperplasia （BPH） patients. We sought to investigate the clinical and urodynamic factors that are associated with the presence of DO in Chinese BPH patients.
