影像尿动力检查在下尿路排尿障碍疾病诊断中的作用

目的 探讨影像尿动力检查在下尿路排尿障碍疾病中的应用价值.方法 2008年12月至2010年3月对115例下尿路排尿障碍患者行影像尿动力检查,确定排尿障碍类型,分析各类疾病的影像尿动力特点.结果 神经原性膀胱患者37例,男性25例,女性12例.其中逼尿肌无反射(DA)18例,膀胱过度活动(OAB)2例,低顺应性膀胱伴肾积水10例,逼尿肌-外括约肌协同失调7例.非神经原性排尿障碍患者59例,男性34例,女性25例;其中膀胱出口梗阻40例,DA 15例,单纯OAB 4例.膀胱扩大术后复查患者7例,男性4例,女性3例.可控回肠膀胱术后男性患者1例.输尿管再植术后男性患者1例.影像尿动力检查显示膀胱尿道功能基本正常者10例,男性6例,女性4例.结论 影像尿动力检查通过压力-流率曲线与实时影像结合分析,可为各类下尿路排尿障碍疾病提供准确的诊断及治疗依据.

Diagnosis of lower urinary tract voiding dysfunction with video-urodynamic studies

Objective To evaluate the role of video-urodynamics (VUD) in the diagnosis of lower urinary tract voiding dysfunction. Methods From December 2008 to March 2010, 115 patients with lower urinary tract voiding dysfunction were included in our study. All patients underwent VUD studies. Results Neurogenic bladder was found in 37 patients, including 25 male patients and 12 female patients. Among these patients, 18 patients were detrusor areflexia( DA ), 2 patients were overactive bladder( OAB), 10 patients were low compliance bladder with hydronephrosis and 7 patients were detrusor-external sphincter dyssynergia. Non-neurogenic voiding dysfunction was found in 59 patients, including 34 male patients and 25 female patients. Among these patients, bladder outlet obstruction was found in 33 patients, OAB in 4 patients, urethra stricture in 4 patients and sphincterismus in 3 patients. Seven patients receiving augmentation of bladder took second VUD examination, including 4 male patients and 3 female patients. One patient receiving Indiana pouch and one patient receiving ureter reimplantation all took VUD examination.Ten patients had basic normal bladder urethra function from VUD examination, including 6 male patients and 4 female patients. Conclusion From combination of pressure-flow figure and real time image, VUD examination provides precise evidence of diagnosis and treatment for lower urinary tract voiding dysfunction.