女性顽固性尿频尿急78例原因分析

目的探讨引起女性顽固性尿频尿急等下尿路症状的原因。方法本组患者78例,年龄23～8548.8±15.6岁。临床表现为尿频、尿急,伴尿痛25例、下腹部或耻骨上区疼痛53例,病程44.5±50.6个月。尿道触诊及按摩,尿液分析及培养;泌尿系超声、IVU;麻醉下尿道膀胱内窥镜检查、膀胱水扩张及黏膜活检。间质性膀胱炎诊断采用NIDDK标准;腺性膀胱炎及内翻性乳头状瘤的诊断根据病理结果;尿道腺炎根据尿道按摩前后尿液白细胞变化、尿道有无触痛及尿道镜检进行诊断。结果间质性膀胱炎37例,水扩张后镜下均有丝球状出血,其中合并hunner溃疡2例;尿道腺炎18例,其中尿道腺管开口处可见脓点11例;腺性膀胱炎17例;内翻性乳头状瘤6例。结论对于顽固性的尿频、尿急,伴有尿痛、下腹部或会阴部疼痛,病程较长,而尿常规正常及尿培养阴性者应进行包括尿道、尿液及膀胱尿道内窥镜等详细的系统检查,可使绝大多数患者获得明确的诊断,以便得到正确的治疗。

The reasons of female refractory lower urinary tract symptoms:Report of 78 cases

Objective To explore the pathogenesis of female lower urinary tract symptoms.Methods Seventy-eight patients were enrolled in this study,and mean course of the patients was about 44.5±50.6 months（2-240）.The mean age was about 48.8± 15.6（23-85）years.Urinary frequency,urgency,voiding pain and lower abdominal or suprapubic pain were the main menifestations.In order to confirm the diagnosis,palpation and massage of urethral,the urine analysis and bacterial culture,IVU,abdominal B ultrasonic,urinary endoscopy,hydrodistention and biopsy of bladder under anesthesia were performed.Interstitial cystitis were diagnosed according to NIDDK criteria and cystitis glandularis,inverted papilloma were referred to pathology.Urethra pancreatitis was done according to changes of white blood cells before and after massage urethra,the urethra with or without tenderness,result of urethroscopy.Results In the 78 patients,37 patients were interstitial cystitis,which glomerulations could be seen under hydrodistention,combined hunner ulcers in 2 patients.18 patients were urethra pancreatitis and abscess of urethra pits could be seen in 11 patients.17 patients were cystitis glandularis.6 patients were inverted papilloma.Conclusions To confirm the pathogenesis of lower urinary tract symptoms,systematic details of urethra,urine,bladde,endoscopy of urinary were strongly need in patient with refractory urinary frequency,urgency,accompanied by dysuria,lower abdominal or perineal pain,especially while the urine analysis and bacteria culture were normal.