慢性前列腺炎患者的尿流动力学检查

目的总结Ⅲ型慢性前列腺炎患者可能存在的下尿路症状,并结合尿流动力学分析各类症状出现的深层次原因。方法对58例Ⅲ型慢性前列腺炎患者的尿流率、膀胱压力容积、压力-流率、前列腺压和肌电图进行综合性回顾分析。并就ⅢA型慢性前列腺炎和ⅢB型慢性前列腺炎的尿动力学变化作了比较。结果41.38%的患者有膀胱活动过度,29.31%的患者有膀胱出口梗阻,另有24.14%的患者存在逼尿肌-外括约肌协同失调。ⅢA型慢性前列腺炎和ⅢB型慢性前列腺炎组中的尿动力学差异无显著性意义。结论慢性前列腺炎患者出现不同程度的尿频、尿急、尿等待和排尿费力等下尿路症状,可能与前列腺局部充血,逼尿肌反射亢进,膀胱出口梗阻和逼尿肌-外括约肌协同失调有关。认识并解除这些相关因素可能有助于提高对慢性前列腺炎的综合疗效。

The urodynamics study in patients with chronic prostatitis (report of 58 cases)

Objective To evaluate the dysfunction of the lower urinary tract of patient with chronic prostatitis （CP） by analyzing urodynamic profile. Methods Our retrospective study was based on 58 patients with type Ⅲ of chronic prostatitis in urology clinics. The clinical data included the measurement of maximum uroflow rate （Qmax）,filling cystometry,pressure-flow （P/Q） study of voiding,prostatic pressure,and electromyography of the external urethral sphincter. Comparative study of urodynamic variation between type ⅢA and type ⅢB of chronic prostatitis was also made. Results 24 patients （41.38%） had bladder hyperactivity,17 patients （29.31%） had bladder outflow obstruction and 14 （24.14%） had detrusor-sphincter coordinated disturbances. The urodynamic difference between type ⅢA and type ⅢB of chronic prostatitis wasn＇t statistically significant. Conclusions The lower urinary tract symptoms,such as urinary frequency,urgency of urination,urinary hesitation and urinary exertion,may be associated with prostate contrafluxion,detrusor hyperreflex,bladder outflow obstruction and detrusor-sphincter coordinatad disturbances. We believe that recognizing and eliminating these relative factors will be helpful to improve synthetic therapy efficacy on chronic prostatitis.