前列腺增生症术后排尿困难的原因及预防

Dysuriaisthemostcommoncomplicationafterhyperplasiaofprostateoperation．Todecreasethehappenofthiscomplication，weanalyzedretrospectivelyallthecasesofdysuriaafterhyperplasiaofprostateoperationinrecent６years，reportasfollow：１Subjectsandmethods１．１Subjects６６casesarefromJan１９９５toJan２００２，age５０～８４，average６７，including５３casesofsuprapubictransvesicalprostatectomyand１３casestransurtheralelectricprostatectomy．１．２MethodsAllthepatientsreceivedurodynamicexamina－tion，includ…     

A computer program for the storage and retrieval of urodynamic data

The computer is idcally suited for storing and retrieving a large volume of medical data. Described herein is a computer program written for the managemenr of data from patients who have had urodynamic evaluation. The program is highly user-oriented and requires only minimal training of personnel. The required hardware is reliable and relatively inexpensive. Further. the program is flexible and easily modified for use in other subspecialty areas of urology.     

Prosultiamine for treatment of lower urinary tract dysfunction accompanied by human T‐lymphotropic virus type 1‐associated myelopathy/tropical spastic paraparesis

Objectives

To evaluate oral prosultiamine treatment in patients with overactive bladder accompanied by human T‐lymphotropic virus type 1‐associated myelopathy/tropical spastic paraparesis.

Methods

This was a prospective, single‐center, open‐label study. Patients received oral prosultiamine (300 mg) once daily in the morning, and the overactive bladder symptom score and urine levels of overactive bladder‐related biomarkers (nerve growth factor/creatinine and adenosine triphosphate/creatinine) 12 weeks after the initial administration were compared with the baseline values. In addition, the urodynamic parameters, including involuntary detrusor contraction and detrusor sphincter dyssynergia, were evaluated before and after treatment.

Results

A total of 16 patients were recruited for this clinical study. In the overactive bladder symptom score, night‐time frequency, urgency and the total score improved after oral prosultiamine treatment (P = 0.028, 0.001 and 0.004, respectively). Both urinary nerve growth factor/creatinine and adenosine triphosphate/creatinine levels decreased significantly after the treatment (P = 0.004 and 0.017, respectively). Urodynamic studies showed that the maximum cystometric capacity increased significantly after the treatment. However, the symptoms disappeared because of the treatment in six of 10 patients with involuntary detrusor contraction (60%) and three of seven patients with detrusor sphincter dyssynergia (42.9%). There were no serious adverse events.

Conclusions

The changes in urodynamic parameters and urine levels of overactive bladder‐related markers suggest that oral prosultiamine is a safe and effective treatment for overactive bladder with human T‐lymphotropic virus type 1‐associated myelopathy/tropical spastic paraparesis.     

女性膀胱过度活动症的尿动力学对照研究

目的探讨女性膀胱过度活动症(overactive bladder,OAB)尿动力学特征。方法采用前瞻性对照研究,筛选临床诊断为OAB的女性患者70例,排尿正常女性志愿者30例为对照组。比较2组尿动力学参数。结果经尿动力学检查诊断为膀胱出口梗阻者2例,其余68例为实验组,纳入统计分析。实验组排尿量(Vv)、平均尿流率(Qave)明显小于对照组(P<0.05)。初始尿意容量(VFD)、强烈尿意容量(VSD)、急迫尿意容量(VUR)、最大膀胱容量(MC)以及膀胱顺应性(BC)均明显小于对照组(P<0.01)。最大尿流率逼尿肌压力(PdetQmax)、膀胱颈压(P1)、最大尿道压(MUP)均明显高于对照组(P<0.01),而最大尿流率(Qmax)在2组间无显著差异。实验组逼尿肌不稳定收缩(DO)发生率明显高于对照组(P<0.01)。实验组中感觉功能过敏发生率明显高于对照组(P<0.01)。结论尿动力学检查是女性OAB患者重要检查手段,结合病史及患者具体情况,对制定个性化治疗方案有指导意义。