前列腺（厚径）^2／宽径计算值与高最大尿流率关系

本文分析８２例男性高最大尿流率与前列腺（厚径）＾２／宽径计算值、排尿前膀胱容积、残余尿及分布，年龄等相关因素，高最大尿流率与前列腺大小形态有关，与逼尿肌增生或膀胱内压升高相关更明显；其残余尿与尿流率大小无关，而残余尿分布与排尿前膀胱容积有关，出现在排尿前膀胱容积大者，年龄相对较小。最大尿流率随年龄增加而降低，但本组中已不再显示年龄均值差异。加之在最大尿流率诺模图标准差区间等综合分析，有助诊断与比较     

1024例儿童尿流率调查

目的 寻求长沙地区儿童尿流率正常值及其列线图。方法 对1024名正常儿童进行1048次尿流率检测。将所得资料按性别、年龄、体表面积、排尿量分组后进行统计学分析，并绘制出各组相应的列线图以阐明尿量、体表面积、平均尿流率、最大尿流率4者的相互关系。结果 正常儿童尿流率曲线为典型的钟形曲线。〈7岁男性儿童的最大尿流率随年龄增加而增加，年龄每增加1岁最大尿流率增加1．7ml／s，〉7岁者其最大尿流率同成年人相仿。〈9岁女性儿童的最大尿流率随年龄增加而增加，年龄每增加1岁最大尿流率增加1．2ml／s，〉9岁其最大尿流率同成年人相近。儿童最大尿流率、平均尿流率及排尿量均随体表面积增加而增加，同时，最大尿流率、平均尿流率也均随排尿量的增加而增加。结论 〈9岁的女童和〈7岁的男童最大尿流率的正常值有明显的年龄依从性。     

剩余分数在膀胱出口梗阻中应用的评价

目的 评价剩余分数在膀胱出口梗阻中的应用。方法 应用B型超声波检测仪及尿流参数自动检测仪对60名患有良性前列腺增生症的门诊患者(尿潴留及神经原性膀胱患者除外)进行排尿前尿量、剩余尿量及最大尿流率测定。分别用剩余分数、剩余尿量与最大尿流率作直线相关分析。结果剩余分数与最大尿流率呈负相关,且相关系数具有极显著意义(r=-0.3425,P<0.01),剩余尿量与最大尿流率也呈负相关,其相关系数具有显著意义(r=-0.2587,p<0.05)。结论 剩余分数值越大,膀胱出口梗阻愈严重,膀胱排尿功能愈差。剩余分数较剩余尿量更能准确地反映膀胱出口梗阻情况。     

前列安栓改善慢性前列腺炎患者尿流率的疗效观察

慢性前列腺炎是青壮年男性常见泌尿科疾病 ,其致病原因很多 ,目前大多学者已认可尿液反流进入前列腺组织引起化学性炎症是其原因之一 ,此类患者出现较为严重的尿频、尿急、排尿不尽、夜尿增多等与排尿相关的症状。在进行尿流率检测时 ,发现相当部分患者出现最大尿流率、平均尿流率等指标异常。我科自 2 0 0 1年 1月开始 ,对 60例尿流率检测异常的慢性前列腺炎患者 ,单独应用前列安栓治疗 ,在症状缓解的同时 ,最大尿流率、平均尿流率获得较好改善。1 　 资料与方法1 .1 　 一般资料本组病例 60例 ,年龄 1 8～ 42岁 ,平均 2 8.6岁。病程 5个月…     

维汉族BPH患者前列腺形态与尿流动力学的相关性

目的 探讨维汉民族前列腺增生患前列腺的体积、症状积分和膀胱排尿症状的相关性。方法 对71例住院手术的维汉不同民族前列腺增生症(BPH)患进行国际前列腺症状评分(BPSS)，生活质量评分(L)，前列腺体积(V)，重量(M)，患年龄(age)，尿流动力学指标的直线相关分析。结果 40例汉族及31例维族BPH患的前列腺体积与膀胱颈压，膀胱颈压与膀胱顺应性，最大尿流率与膀胱顺应性均呈正相关。结论 最大尿流率、前列腺体积、膀胱顺应性、膀胱颈压四个参数不但能了解膀胱排尿功能和形态改变，也可做为临床上手术切除增生前列腺组织，解除梗阻，缓解症状，评价治疗效果的指标。     

前列腺增生患者尿流动力学检查后尿路感染发生率及危险因素分析

目的探讨前列腺增生患者完成尿流动力学检查后尿路感染发生率及相关危险因素。 方法选取2012年1月至2017年6月在我院行尿流动力学检查的前列腺增生患者540例，其尿流动力学检查前尿液分析白细胞≤18个/μl且中段尿培养阴性；检查完成后24～48 h内收集尿液行尿液分析及尿培养，尿液分析白细胞>18个/μl及中段尿培养阳性代表发生尿路感染。对入选患者的特征及相关尿流动力学参数进行分析对比。 结果540例前列腺增生患者完成尿流动力学检查，其中45例患者发生尿路感染，发生率为8.33%，其相关危险因素为糖尿病、膀胱出口梗阻、膀胱残余尿量、前列腺体积和最大尿流率及平均尿流率，最常见的致病菌为大肠埃希氏菌及肠球菌（51%，20%）。 结论患者合并糖尿病、膀胱出口梗阻、残余尿量越多、前列腺体积越大、最大尿流率越低、平均尿流率越低尿流动力学检查后尿路感染发生率越高，这部分患者适当接受抗生素治疗可能获益，。     

前列腺移行区指数与压力—流率同步尿动力学检查的临床研究

目的：探讨前列腺移行区指数与压力－流率尿动力学检查的关系。方法：选择82例前列腺增生（BPH）患者行经直肠前列B超及尿动力学压力－流率同步检查,观察前列腺移行区体积及前列腺移行区指数（TZI）、最大尿流率（Qmax)和最大尿流率时膀胱收缩压力（PdetQmax)等指标,并将结果进行统计学相关分析。结果：TZI与Qmax及PdetQmax相关系数（r)分别为－0.346和0．261,P＜0．05和＞0．05。结论：TZI与Qmax呈显著负相关,与PdetQmax关系不肯定。     

膀胱压减去尿道出口压与最大尿流率比率测定诊断膀胱出口梗阻的临床价值

目的：探讨膀胱压(Pvas)减去尿道出口压(P0)比最大尿流率(Qmax)比率的测定(Pves—P0／Qmax)对诊断膀胱出口梗阻(BOO)的可靠性。方法：采用WIEST尿动力学仪，53例患者分为逼尿肌低压低尿流率、高压高尿流率、高压低尿流率、高压伴正常尿流率、正常逼尿肌压伴正常尿流率5种不同排尿类型，应用Pves-P0／Qmax测定诊断BOO，同时应用ICS标准方法即Pves减去腹压(Pabd)比最大尿流率(Qmax)的测定(Pves—Pabd／Qmax)诊断B00；用两种方法判别BOO并进行自身对比。结果：18例逼尿肌低压低尿流率以及高压高尿流率患者，应用ICS标准方法Pves-Pabd／Qmax测定不能明确诊断有否BOO，但应用Pves—P0／Qmax测定能明确诊断有否BOO；35例逼尿肌高压伴低尿流率或伴正常尿流率以及正常逼尿肌压伴正常尿流率的患者，应用两种方法诊断有否BOO结果基本一致。结论：应用Pves-P0／Qmax测定诊断BOO对各种排尿类型有普遍的可靠性，特别对逼尿肌低压低尿流率或高压高尿流率病例能明确判定有否BOO。     

非干扰性排尿期尿道造影录像与尿流率同步测定诊断膀胱出口梗阻

目的：探讨排尿期尿道造影录像与尿流率同步测定，对诊断膀胱出口梗阻(BOO)的意义。方法：对有无前列腺增生两组各30例患者分别进行非干扰性动态排尿期尿道造影录像与尿流率同步测定。两组采用改良的尿道阻力因子列线图判明BOO与非BOO。结果：30例前列腺增生组中26例诊断BOO，4例诊断可疑B00；30例非前列腺增生组均诊断非BOO.结论：动态排尿期尿道造影录像与尿流率同步测定对于诊断BOO是一种较好的、非干扰性的复合式尿动力学检测方法。     

回肠正位代膀胱的尿动力学检测

目的：从尿动力学角度阐明回肠代膀胱的尿动力学特点，并为该术式提供动力学依据。方法：对1991年6月-1998年9月间作回肠代膀胱术26例患者用Dantec-Menuet尿动力仪行尿流率，代膀胱压力。容积和尿道压等检查。结果：最大尿流率为16.4(5.0-28.0)ml/s。代膀胱的最大容积为424.5(240-803)ml。贮尿囊最大内压为2.695(2.060-4.606)kPa。排尿时贮尿囊内压为7.918(4.508-10.486)kPa。最大尿道闭合压为6.292(4.900-7.742)kPa。结论：回肠代膀胱具有较大的容积。能满足贮尿功能，有足够大的尿道压和较低的膀胱压，保证了可控性，排尿期膀胱压远大于尿道压，为原位排尿提供了保障，是一种理想的膀胱替代术。     

Clinical evaluation of patients with prostatic obstruction: correlation of flow rates with voided, residual or total bladder volume

Previous investigators reported that accurate estimation of average or maximum urinary flow rates required correlation with total bladder volume (voided plus residual volumes). To test this requirement we performed uroflowmetry studies on 124 patients before and 77 patients after prostatectomy. Of the patients 20 were tested on multiple preoperative and postoperative occasions to comprise paired observations. Observations were made on age, voided and residual volumes, voiding duration, and average, maximum and adjusted maximum flow rates. Prostatectomy resulted in significant increases in all flow rates and significant decreases in voiding duration. The procedure had significant effects on reducing residual volume but voided volumes increased and total volume decreased only slightly postoperatively. Preoperative average, maximum and adjusted peak urinary flow rates correlated negatively with residual volume (increasing residual volume correlates with decreasing flow rate). Maximum flow rates correlated positively with voided volume. Whether measured preoperatively or postoperatively no significant correlation was found among average, peak or adjusted flow rates and total bladder volume. The only consistent significant correlation found among voided, residual and total volumes, and other measurements was voiding duration, which increased as any of the aforementioned volumes increased. Comparison of the random total and paired populations revealed no significant difference. Use of voided rather than total volume seems preferred in correlations with maximum urinary flow rates. Determination of residual urine remains necessary as an estimation of emptying failure but it is not required information for determination of flow rates.     

New method of measuring uroflow in the rat bladder

Urodynamic evaluation of bladder function requires the simultaneous measurement of detrusor pressure and uroflow. Although the rat is a common animal model to study several bladder dysfunctions, including partial outlet obstruction, one of the major problems is that the bladder capacity has been too small for the measurement of uroflow. We have developed a new method of measuring uroflow in the rat that is sensitive at low bladder volumes. The method is based on the change in conductance of the gap between two silver electrodes in a measuring chamber as the chamber fills with saline during voiding. An AC voltage supply drives a current through the saline. As the saline level rises in the chamber the conductance increases, with a corresponding increase in current flow. A linear correlation between time rate of change of electrical current and fluid flow rate exists over a wide range of values and suggests that this new rat flowmeter is both accurate and reproducible. © 1992 Wiley-Liss, Inc.     

Differences between the data from free flow and intubated flow in women with urinary incontinence. What do they mean?

AIMS: To assess the effects of a urethral catheter on the urodynamic data extracted from uroflow in women, and to interpret the differences from free uroflow using the VBN mathematical micturition model. METHODS: Urodynamic data of 217 consecutive (June 2002 to December 2004) women with urinary incontinence and without neurological disease or more than grade 2 prolapse were reviewed. Inclusion criteria were to perform one free flow (FF) and one intubated flow (IF) (voided volumes of at least 100 ml and continuous flow curves). Voiding parameters: volumes, maximum flow rate, detrusor pressure and flow time, were analyzed as some characteristic ratios. The VBN model was used to make simulations of various pathophysiological hypotheses. RESULTS: Significant increased residual volume and flow time, decreased maximum flow rate were observed during IF. Twenty five patients had a residual volume only during IF; in that group, both decrease of Q(max) and increase of flow time were significant. Simulations showed that the geometrical effect of the catheter was not the only cause and allowed to propose the occurrence of a compression-like effect of the urethra and of a fading of the detrusor excitation after Q(max) to explain the results. CONCLUSION: Significant differences were found between the data from a FF and an IF in women with urinary incontinence. These findings bring to the fore the impact of the transurethral catheter and underline the necessity to obtain at least one FF and one IF during a urodynamic session.     

Predictive value of low maximum flow rate in benign prostatic hyperplasia

Among 84 patients with prostatism selected for transurethral resection of the prostate, 18 had a maximum flow at spontaneous uroflowmetry less than or equal to 7 ml/sec. Preoperatively there was no significant difference between patients with maximum flow less than or equal to 7 ml/sec (Group 1) and patients with maximum flow greater than 7 ml/sec (Group 2) in age, duration of symptoms, symptom scores, bladder volume, residual urine, and detrusor pressure at maximum flow. Patients in Group 1, however, had significantly lower urethral resistance and bladder volume independent maximum flow than patients in Group 2. Postoperatively, patients with preoperative maximum flow less than or equal to 7 ml/sec improved significantly in symptom scores and urodynamic findings apart from bladder volume and detrusor pressure at maximum flow. There were no significant differences between groups in postoperative symptom scores or urodynamic findings. We conclude that preoperative maximum flow rates less than or equal to 7 ml/sec at spontaneous uroflowmetry were related to high urethral resistance and not detrusor decompensation among patients with prostatism, and that patients with maximum flow rates less than or equal to 7 ml/sec fared as well postoperatively as patients with maximum flow greater than 7 ml/sec.     

Influence of Prostate Size on Terazosin Efficacy

Background: While the rationale for the use of α1-adrenoreceptor antagonists in the treatment of bladder outlet obstruction is well established, not all patients have either objective or subjective improvement. The aim of this study was to evaluate the influence of prostatic size on the changes of peak flow rate, average flow rate and residual urine in symptomatic BPH patients undergoing terazosin treatment.
Methods: Thirty-five patients with symptomatic BPH received terazosin, 5mg once a day for 3 weeks after a 2-week dose escalation period. Peak and average flow rates as well as residual urine were assessed before and after treatment. The patients were stratified in 3 groups by prostate size, which was estimated by transabdominal ultrasonography and a digital rectal examination.
Results: The baseline characteristics for age, peak flow rate and average flow rate did not vary between the 3 groups, however, the pretreatment volume of residual urine was greater in patients with large prostate adenomas. Terazosin treatment resulted in significant changes in flow rate and residual urine, however, changes in flow rates were not influenced by prostate size, while a marked decrease in residual urine was found in patients with large prostates.
Conclusion: Patients treated with terazosin obtained similar improvement in peak and average uroflow, independent of the size of the prostate.     

Primary bladder neck dysfunction in children and adolescents II: results of treatment with alpha-adrenergic antagonists

PURPOSE: Little has been reported on the occurrence of primary bladder neck dysfunction (PBND) in the pediatric patient, particularly as it relates to the use of alpha-blocker therapy, the mainstay of medical therapy in adults. Diagnosed on videourodynamics (VUDS), PBND is characterized by the constellation of prolonged opening time, incomplete bladder neck funneling, quiet pelvic floor electromyogram (EMG) during voiding and abnormal pressure flow parameters. We report the VUDS findings in PBND and our experience with alpha-blocker therapy in the pediatric and adolescent population. MATERIALS AND METHODS: A total of 34 symptomatic patients met all VUDS criteria for PBND, and alpha-blocker therapy was initiated in 26. All patients were monitored with serial noninvasive uroflow studies with pelvic floor EMG (uroflow/EMG) before and after initiation of alpha-blocker therapy. Objective clinical response was assessed by measuring average and maximum uroflow rates, post-void residual urine volumes and pelvic floor EMG lag time, a correlate of opening time. RESULTS: A total of 26 patients with PBND (20 males, 6 females) 5.5 to 20 years old at initiation of therapy (mean age 12.8 years) were treated with alpha-blockers. Mean average and maximum uroflow rates improved from 5.5 to 12.6 cc per second and from 10.3 to 19.7 cc per second, respectively, while mean EMG lag time decreased from 24.4 to 5.7 seconds and post-void residual urine volume from 98.9 to 8.9 cc (all p <0.001). Mean followup was 31 months, with all patients reporting significant symptomatic improvement. No patient experienced any major adverse side effects. The 8 patients with PBND who refused alpha-blocker therapy had no improvement symptomatically or urodynamically with time, and those who discontinued therapy had a return to pretreatment values. CONCLUSIONS: PBND is an often overlooked but significant cause of voiding dysfunction in children and adolescents. In our experience alpha-blockers are clinically effective therapy for PBND and have been reasonably well tolerated in our young patients for what may possibly be a lifelong problem.     

女性糖尿病患者膀胱功能障碍的尿动力学研究

目的：探讨尿动力学检查在糖尿病患者膀胱功能障碍诊断中的意义。方法：回顾性分析32例女性糖尿病膀胱病变患者的临床资料和尿动力学检查结果,明确尿动力学的特征性改变。结果：早期组最大尿流率、膀胱容量下降,逼尿肌压力增加,初始尿意、剩余尿量正常;晚期组最大尿流率、逼尿肌压力下降明显,初始尿意、剩余尿、膀胱容量显著增加。结论：女性伴有下尿路症状（LUTS）的糖尿病患者膀胱功能异常的发生率高,随着病程延长,膀胱功能改变明显。尿动力学检查可以明确膀胱功能,对合并糖尿病的LUTS患者的正确诊断和治疗具有重要的指导意义。     

Uroflowmetry: its current clinical utility for women

Uroflowmetry, the simple, non-invasive measurement of urine flow over time during micturition, has a long and interesting history, clear definitions, a clear purpose in screening for voiding difficulty and, most importantly, technical accuracy. Data interpretation is currently limiting its clinical utility, despite appropriate analysis being available in long-standing existing research. The main clinically important numerical parameters are the maximum and average urine flow rates and the voided volume. Urine flow rates are strongly dependent on voided volume. Reference to established (Liverpool) nomograms will most accurately correct for this dependency. Nomograms will also optimise the validation of uroflowmetry data and the accurate assessment of its normality, compared with fixed urine flow rates and "cutoffs" for voided volume. Abnormally slow urine flow (under the 10th centile Liverpool Nomograms) is the most clinically significant abnormality. Repeat uroflowmetry, concomitant post-void residual measurement and voiding cystometry studies are appropriate options for evaluating any abnormal uroflowmetry.     

Characteristics of detrusor contractility during micturition in diabetics.

Pressure-flow studies were performed in 26 diabetics without bladder-outlet obstruction to objectively quantify detrusor activity and its variance during micturition by using the watts factor (WF) and to clarify the factors inducing a post-void residual volume (PVR). The WFmax values obtained from the pressure-flow studies were low in the majority of diabetics. There was a significant negative correlation between WFmax and PVR. A fading contraction strength during voiding was also observed that gave rise to an increased volume of residual urine, indicating that detrusor activity could not be maintained until the bladder was completely emptied in the diabetics. A positive correlation between bladder capacity and PVR was also observed. Our results indicate that residual urine in diabetics is related to a decrease in the maximum detrusor contraction strength, the fading of detrusor contractility during voiding, and an increase in the size of the bladder.