尿动力学检查在青年男性下尿路症状患者中的应用

目的评价尿动力学检查在青年男性下尿路症状(LUTS)患者中的临床应用价值.方法 回顾性分析189例18~40岁的青年男性下尿路症状患者的尿动力学检查资料.排除有糖尿病史、退行性神经系统疾病、泌尿系统外伤、手术史或急性尿路感染的患者.所有患者均接受多通道的尿动力学检查并对检查前后的诊断进行比较.结果 189例患者平均年龄(29.1±5.6)岁,147例(78%)有潴尿期症状,而121例(64%)有排尿期症状.尿动力学检查前诊断主要有慢性前列腺炎/前列腺痛37例(20%)、神经源性膀胱46例(24%)、膀胱过度活动症63例(33%)和其他43例(23%).104例(65%)患者出现异常尿动力学检查结果,包括膀胱顺应性降低24例(13%),膀胱逼尿肌过度活动87例(46%),逼尿肌-外括约肌协同失调13例(7%),膀胱出口梗阻57例(30%)和逼尿肌活动低下/无收缩32例(17%).结论 青年男性LUTS患者的流行病学病因多种多样;临床诊断和治疗常依靠经验,并不准确;尿动力学检查在评价青年男性LUTS患者中具有重要价值.     

尿动力学检查在以LUTS为主要症状的慢性前列腺炎患者诊断治疗中的应用

目的探讨尿动力学检查在疑似慢性前列腺炎的青年男性伴下尿路症状(LUTS)患者评价中的临床应用价值。方法回顾性分析了63例17～39岁的临床疑似慢性前列腺炎的青年男性伴LUTS患者的尿动力学检查资料。排除有糖尿病史、神经源性疾病、泌尿系统外伤、手术史或急性尿路感染的患者。所有患者均接受多通道的尿动力学检查。对检查前后的诊断进行比较。结果 63例患者平均年龄为(26.7±3.9)岁;74.6%(47/63例)有储尿期症状,66.7%(42/63例)有排尿期症状。74.6%(47/63例)患者出现异常尿动力学检查结果,包括顺应性降低22.2%(14/63例),逼尿肌过度活动25.4%(16/63例);逼尿肌-外括约肌协同失调15.9%(10/63例),膀胱出口梗阻30.2%(19/63例)和逼尿肌收缩力降低或逼尿肌无收缩17.5%(11/63例)。结论临床疑似慢性前列腺炎的青年男性伴LUTS患者的流行病学病因多种多样。临床诊断和治疗常依靠经验,并不准确。尿动力学检查在评价临床疑似慢性前列腺炎的青年男性伴LUTS患者中具有重要价值。     

利多卡因乳膏减轻男性下尿路手术后尿管相关刺激症状的效果

目的探讨利多卡因乳膏能否减轻接受下尿路手术的男性患者术后尿管相关刺激症状(CRBD)。方法将择期于全身麻醉下接受下尿路手术、术后需留置20号或22号三腔尿管的男性患者80例随机分为乳膏组(40例)和对照组(40例)。乳膏组插尿管前于其前端涂抹利多卡因乳膏5 g再行导尿,对照组则行常规导尿。记录麻醉诱导前(T1)、手术结束时(T2)、喉罩拔出后5 min(T3)、30 min(T4)和2 h(T5)5个时间点的心率和平均血压。评估2组患者T3、T4、T5的CRBD发生率及其严重程度。结果乳膏组T3、T4的心率和平均血压均低于对照组(P均<0.05)。乳膏组T3、T4时中至重度CRBD的发生率低于对照组(P均<0.05)。结论全身麻醉下行下尿路手术后,对于需留置20号或22号三腔尿管的男性患者,利多卡因乳膏可降低其术后2 h内中至重度CRBD的发生率,且能使全身麻醉苏醒期的血流动力学更平稳。     

深圳某社区青年女性下尿路症状的问卷调查研究

目的：分析青年女性人群下尿路症状（LUTS）的发病率和相关影响因素。方法：对广东省深圳市某社区青年女性人群进行随机抽样问卷凋查（问卷设计参考女性下尿路症状国际尿失禁标准问卷（ICIQFLUT）、国际前列腺状问卷（IPSS）布里斯托女性下尿路症状（BFLUTS）问卷及生活质量（QoL）等],根据具体情况进行调整。问卷由被调查者独立填写。结果：调查共发出问卷1500份,回收有效问卷1387份。储尿症状总患病率为91．2％,随年龄的增加,总储尿症状患病率呈增高趋势（P〈0．01）,与年龄和分娩方式有关;排尿症状总患病率为65．2％,随年龄的增加,总储尿症状患病率呈增高趋势（P〈0．01）,与生育情况、分娩方式以及文化水平有关。受调查者以刺激症状和梗阻症状的生活质量进行评分,分别为（2．87±1．32）分和（2．23±1．05）分;刺激症状和梗阻症状与生活质量评分的关联系数分别为0．51和0．23。结论：青年女性人群中的LUTS患病率很高,且不同程度影响青年女性的生活质量。     

慢性前列腺炎患者的尿动力学研究进展

慢性前列腺炎(chronic prostatitis,CP)是指发牛于前列腺的慢性炎症反应,是中青年男性最常见的泌尿牛殖系统疾病之一,其临床症状呈多样化表现,排尿异常是其最常见和最难治的主要症状之一.具体表现为:尿频、尿急、尿痛、尿道灼热、尿道滴白、尿分叉、尿滴沥不尽、尿细无力等,症状时轻时重或反复发作,严重影响男性躯体和心理健康.50%的男性一生中曾出现过前列腺炎症状,就诊者约占泌尿外科门诊患者的25%.目前对CP的诊治尚有误区,而尿动力学分析能对各类尿路功能障碍做出客观评价,本文就CP在尿动力学方面的研究作一综述.     

氯胺酮导致下尿路症状的研究进展

氯胺酮导致下尿路症状是一种由于长期吸食氯胺酮导致的一种以尿频、尿急、夜尿增多伴有耻骨上疼痛的综合征。近几年临床工作者开始重视氯胺酮对于泌尿系统的损害,开展了一系列调查和研究,包括对发病机制、病理特点、治疗方案的研究。但该病的病因、命名和诊断仍不清楚,治疗多为对症治疗。本文检索了近年来发表的相关文献,以探究氯胺酮导致下尿路症状。     

慢性前列腺炎患者的尿动力学研究进展

慢性前列腺炎(chronic prostatitis,CP)是指发牛于前列腺的慢性炎症反应,是中青年男性最常见的泌尿牛殖系统疾病之一,其临床症状呈多样化表现,排尿异常是其最常见和最难治的主要症状之一.具体表现为:尿频、尿急、尿痛、尿道灼热、尿道滴白、尿分叉、尿滴沥不尽、尿细无力等,症状时轻时重或反复发作,严重影响男性躯体和心理健康.50%的男性一生中曾出现过前列腺炎症状,就诊者约占泌尿外科门诊患者的25%.目前对CP的诊治尚有误区,而尿动力学分析能对各类尿路功能障碍做出客观评价,本文就CP在尿动力学方面的研究作一综述.     

慢性前列腺炎患者的尿动力学研究进展

慢性前列腺炎(chronic prostatitis,CP)是指发牛于前列腺的慢性炎症反应,是中青年男性最常见的泌尿牛殖系统疾病之一,其临床症状呈多样化表现,排尿异常是其最常见和最难治的主要症状之一.具体表现为:尿频、尿急、尿痛、尿道灼热、尿道滴白、尿分叉、尿滴沥不尽、尿细无力等,症状时轻时重或反复发作,严重影响男性躯体和心理健康.50%的男性一生中曾出现过前列腺炎症状,就诊者约占泌尿外科门诊患者的25%.目前对CP的诊治尚有误区,而尿动力学分析能对各类尿路功能障碍做出客观评价,本文就CP在尿动力学方面的研究作一综述.     

232例尿动力学检查的护理

尿动力学是泌尿外科学一个新的研究领域，是利用流体力学的基本原理研究尿路输、储存、以及尿液排除体外的动态过程。是临床上用于诊断下尿路疾病的检查方法之一。我科自1999年6月至2001年10月共做尿动力学检查232例，由于注重了检查前的准备、心理护理、检查中的密切观察和护理，以及检查后的正确指导等措施，取得了很好的临床效果。     

下尿路尿动力学检查病人的护理

总结了640例下尿路尿动力学检查病人的护理体会。认为检查前对病人既往的症状进行评估,能为检查提供参考信息;检查前做好病人的配合指导是检查成功的基础;外置式压力传感器调整零位,确保传感器及与之连接的导管和测压管内无空气、导管通畅、各连接口无渗漏、测压导管位置正确及选择适当的灌注速度是检查质量的保证;掌握检查适应证,有利于减少并发症的发生。     

Nurses leading male lower urinary tract symptom (LUTS) clinics: A scoping review

Nurse-led clinics are known to positively impact and benefit patients; however, there is little understanding of the role of the nurse in a nurse-led male Lower Urinary Tract Symptoms (LUTS) clinic. LUTS affect up to 30% of males over 65 in the United Kingdom and can significantly impact the quality of life of the person experiencing them. LUTS can be managed with conservative changes, as well as with medication and surgical intervention. The aim of this scoping review is to map what is known about the role of the nurse in a nurse-led male LUTS clinic and what research tells us regarding, the barriers and enablers in nurses leading a male LUTS clinic. This scoping review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-SCR) checklist and the methodological guidelines set out by the Joanna Briggs institute. A literature search was carried out over three databases (CINAHL, Medline Ovid, ProQuest health and medical collection) and systematically searched from 2000 to 2021. Grey literature was also searched, and citation chaining was undertaken. Following a systematic review of the literature, four papers met the inclusion criteria for this scoping review. The emergent themes across the four papers consisted of structure, assessment and resources, and effectiveness of the nurse-led male LUTS clinic. There was clear agreement across the literature regarding the investigations and assessment the nurse should carry out. Ongoing practical, theoretical, and observational training and education is required to ensure the nurse is competent in running a male LUTS clinic. The papers reviewed showed the nurse provided a supportive role to the consultant. However, there is evidence indicating there is a move towards autonomous practice. There is a dearth of the current research relating to the role of the nurse in nurse-led male LUTS clinics and the enablers and barriers in nurses leading male LUTS clinics. Further research should be considered to gain a better understanding of where nurse-led male LUTS clinics currently take place, what the role of the nurse is in leading a LUTS clinic and what enablers and barriers exist.     

Different antibiotic regimes in men diagnosed with lower urinary tract infection – a retrospective register-based study

Abstract

Objective

To compare the proportion of therapy failure, recurrence and complications within 30?days after consultation between men diagnosed with lower urinary tract infection (UTI) treated with narrow-spectrum antibiotics (nitrofurantoin or pivmecillinam) and broad-spectrum antibiotics (fluoroquinolones or trimethoprim or trimethoprim/sulfamethoxazole).     

下尿路梗阻性肾积水尿动力学检查的护理干预

目的探讨护理干预措施在下尿路梗阻性肾积水患者尿动力学检查中的应用价值。方法选取下尿路梗阻患者468例,所有患者均经超声或静脉肾盂造影证实存在肾积水。在尿动力学检查的不同阶段,对影响检查结果的各种因素采取有效的护理干预措施,实时测定检查过程中的质量控制。结果所有患者均顺利完成了尿动力学检查,并获得准确而满意的检查结果。结论采取积极有效的护理干预措施,可保证下尿路梗阻性肾积水患者尿动力学检查的成功率和结果的准确性以及有效预防检查术后并发症的发生。     

尿动力学中心护理工作的实施

尿动力学检查是下尿路功能障碍诊断的标准方法,因其为功能性检查,检查结果受到多种因素的影响。加强尿动力学中心护理工作、改善检查环境、保护患者隐私、积极健康教育和正确引导,从多方面对患者进行心理护理,有助于提高尿动力学检查结果的准确性和可重复性,并可促进尿动力学中心发展。     

Measuring resistance index in patients with BPH and lower urinary tract symptoms

PURPOSE: To assess the correlation between resistance index (RI) measured in different zones of the prostate and other more commonly used parameters of benign prostatic hyperplasia (BPH). METHODS: Twenty-six male patients who underwent a detailed evaluation for lower urinary tract symptoms suggestive of BPH were examined with transrectal (TRUS) color Doppler sonography (CDS). The correlation between RI in various prostate zones, and various urinary flow rates, and the International Prostate Symptom Score (IPSS), and prostatic volume measured by TRUS was determined. RESULTS: No significant difference in RI was observed between right and left transition (TZ) and peripheral zones (PZ) in the prostate (P > 0.05). There was a significant correlation between mean RI and maximum urinary flow rate (Qmax) and mean RI in both zones (r = -0.48 for TZ and r = -0.39, P < 0.05 for PZ). Individual measurements in left and right TZ RI were also correlated with Qmax. There was a correlation between prostatic volume and both the right (P < 0.05, r = 0.56) and the left (P < 0.05, r = 0.58) TZ RI, respectively. CONCLUSION: Our results demonstrate the potential value of RI measurement in the evaluation of patients with lower urinary tract symptoms suggestive of BPH.     

Development of a self-management scale for lower urinary tract symptoms in patients with cancer after radical prostatectomy

How can nurses assess the self-management of lower urinary tract symptoms (LUTS) in patients with cancer after radical prostatectomy (RP)? Patients with prostate cancer who have undergone RP experience multiple LUTS. This study aimed to develop a self-management scale for LUTS in patients with cancer following RP (SMS-LUTS-RP), as well as to verify its reliability and validity. LUTS has physical, social, and psychological consequences for patients. As a result, patients are forced to self-manage their LUTS and LUTS-related issues. However, no indicators exist to assess self-management of LUTS. A total of 246 individuals were surveyed. A 49-item scale draft, whose content validity and face validity were confirmed, was used to develop a questionnaire for patients with LUTS after RP. The reliability and validity were determined using by item analysis, exploratory factor analysis, confirmatory factor analysis, and Cronbach's α coefficient. The exploratory factor analysis produced the following 18 items on five extracted factors: ‘monitoring of urinary status,’ ‘coping with daily life difficulties due to LUTS,’ ‘collaboration with medical professionals,’ ‘continued training to improve LUTS,’ and ‘living with LUTS.’ The goodness-of-fit-index (GFI) for confirmatory factor analysis was 0.876, and the root mean square error of approximation was 0.075. Cronbach's α coefficient was 0.754–0.820. SMS-LUTS-RP has desirable psychometric properties and can assess the cognitive and behavioural aspects of self-management of LUTS in patients with cancer who have undergone a RP. This scale can be used to provide individualized self-management support according to living conditions.     

尿流动力学在女性压力性尿失禁TVT-O手术治疗中的临床价值

目的探讨尿流动力学在女性压力性尿失禁TVT-O手术治疗中的临床价值。方法采用TVT-O手术治疗26例女性压力性尿失禁患者。检测患者术前术后尿流动力学结果,并进行对比。根据患者主诉,排尿正常、完全自控、无尿失禁为治愈,尿失禁减少〉50%为改善。结果 26例患者手术后主观症状均明显改善。其中主观治愈24例,主观改善2例。尿流动力学检测指标中,最大尿流率在治疗前后无明显改变（P〉0.05）,最大尿道压和腹压漏尿点压力在治疗前后有明显改变（P〈0.05）,最大尿道闭合压（MUCP）在术前均为负值,术后均为正值。结论尿流动力学对于女性压力性尿失禁患者选择恰当的治疗方案,以及对TVT-O手术治疗效果的评估有着重要临床价值。     

Assessment,diagnosis and management of lower urinary tract symptoms in men

Lower urinary tract symptoms are very common and the approach to assessment and management has changed dramatically over the past few years. Previously referred to as prostatism, benign prostatic hyperplasia and bladder outflow obstruction, it is now recognised that in most men symptoms are due to a combination of benign prostatic enlargement and age-related bladder dysfunction. Most men require only simple tests for a diagnosis, with the more complex investigations reserved for when the diagnosis is not clear. Symptom bothersomeness and effect on quality of life are the critical factors when deciding how to treat a man. A cascade of treatments exists, including conservative management, medical therapy and surgery. A man moves up the cascade when the present management strategy fails to control symptoms. Traditional surgical techniques such as transurethral resection of the prostate are still appropriate for some men, although with improved medical treatments available the number of men undergoing surgery is declining.