原发性膀胱颈梗阻/原发性膀胱颈协同失调的诊断与治疗现状

原发性膀胱颈梗阻(primary bladder neck obstruction,PBNO)/原发性膀胱颈协同失调(primary bladder neck dyssynergia,PBND)是一组病因不明的膀胱颈梗阻综合征,临床表现为排尿期症状(排尿费力、尿踌躇、尿流变细、排空不全等)、储尿期症状(尿频、尿急、尿失禁、夜尿等)或两者同时存在。影像尿动力检查(video-urodynamic study,VUDS)是诊断PBNO/PBND的金标准,PBNO/PBND特征为高压低流的排尿模式,在影像透视下可见膀胱颈未开放或开放不全。轻症患者可采取观察、药物治疗及间歇清洁自家导尿等措施进行保守治疗,保守治疗无效的患者应行经尿道膀胱颈电切术。为进一步了解PBNO/PBND及其进展,本文就相关研究进展进行综述。

Diagnosis and treatment of primary bladder neck obstruction or primary bladder neck dyssynergia

Primary bladder neck obstruction or primary bladder neck dyssynergia (PBNO/PBND) is a set of specific bladder neck obstruction syndrome, the precise cause of PBNO/PBND has not been clearly elucidated, PBNO/PBND may present with a variety of symptoms, including voiding symptoms (dysuria, hesitation, straining, incomplete emptying), storage symptoms (frequency, urgency, urinary incontinence, nocturia) or a combination of both. It is considered that video-urodynamic study (VUDS) is the gold standard for the diagnosis of this disease, PBNO/PBND is a video urodynamic diagnosis whose hallmarks include high-pressure low-flow voiding, and radiographic evidence of bladder neck is not open or incomplete. Treatment for some patients with slight symptoms can choose observation, pharmacological treatment and clean intermittent self-catheterization, for patients who failed to receive conservative treatment should be performed transurethral bladder neck incision. To further understand PBNO/PBND and its progress, this article reviews the relevant research progress.