女性下尿路症状的影像尿动力学评价

目的探讨女性下尿路症状患者的影像尿动力学异常表现及临床意义。方法选择38例门诊主诉持续下尿路症状就诊的女性患者，采用15％泛影葡胺溶液为膀胱灌注液。根据膀胱测压、压力-流率、盆底肌电图以及X线影像等对患者下尿路症状进行诊断，并比较尿动力学正常和异常患者的I-PSS评分。结果38例中影像尿动力学异常23例，占60．5％，其中感觉性尿急迫6例，不稳定膀胱（DI）5例，假性逼尿肌一括约肌协同障碍（PDS）4例，PDS＋DI2例，尿道外口狭窄2例，DI＋急迫尿失禁、低顺应性膀胱、膀胱颈后唇增生以及近端尿道憩室各1例。结论影像尿动力学检查不仅可以了解女性下尿路症状患者的下尿路功能和形态变化，且有助于不同病变类型的诊断和治疗。

Urodynamic evaluation for women with lower urinary tract symptoms

Objective To evaluate the video urodynamic abnormalities of women with lower urinary tract symptoms.Methods 38 females with lower urinary tract symptoms underwent video urodynamic test.Filling cystometry was done with 15% urographin saline fluid.A diagnosis was made in each case based on cystometrography finding,voiding pressure flow study,EMG and fluoroscopic appearance.Results Video urodynamic showed abnormalities in 23 cases(60.5%),including sensory urgency in 6,detrusor instability(DI) in 5,pseudodyssynergia(PDS) in 4,PDS+DI in 2,urethral orifice stricture in 2,DI+urgency incontinence in 1,impaired compliance in 1,bladder neck stricture in 1 and urethral diverticulum in 1.Conclusion Video urodynamic is useful not only for understanding the abnormalities of functions and morphology of women with lower urinary tract symptoms,but also for properly diagnosing and treating such cases.