排尿期尿道测压在BPH中的应用价值

目的探讨前列腺增生症（ＢＰＨ）致膀胱流出道梗阻（ＢＯＯ），及其相关问题。方法采用排尿期尿道测压（ＭＵＰＰ）检测４３例ＢＰＨ患者，以压力下降梯度（ＭＵＰＰＧ）计算梗阻程度，同时行膀胱等容收缩试验测最大逼尿肌等容收缩压（Ｐｉｓｏ）；进行国际前列腺症状评分（ＩＰＳＳ），经腹壁Ｂ超测前列腺体积（Ｖ）。结果４３例ＢＰＨ中３８例存在ＢＯＯ（８８％），梗阻位于膀胱颈部２８例（７７％）；ＭＵＰＰＧ与ＩＰＳＳ、Ｖ、Ｐｉｓｏ呈正相关。结论ＭＵＰＰ能检测并计算ＢＯＯ程度；ＢＯＯ是ＢＰＨ的病理基础，临床症状、逼尿肌代偿与其相关。

Clinical significance of micturitional urethral pressure profilometry in benign prostatic hyperplasia

Objective To increase the understanding of clinical manifestations of benign prostatic hyperplasia (BPH). Methods 43 inpatiants with BPH were studied.Symptoms were assessed with international prostatic symptom score (IPSS).Prostate volume (V) was estimated by transabdominal ultrasonography.The maximum isometric contraction pressure (Piso) was meassured by the continuous occlusion test,and bladder outlet obstruction (BOO) was meassured by micturitional urethral pressure profilometry (MUPP).The severity of the obstruction was determined by the magnitude of the micturitional urethral pressure profile gradiend (MUPPG). Results 38 out of 43 cases suffered from BOO (88%).There were 28 cases with obstruction near bladder neck (77%).There was significant correlation between MUPPG and IPSS( r =0.5083,, P =0.003);between MUPPG and V( r =0.4472,, P =0.018);between IPSS and V( r =0.3651,, P =0.022);between MUPPG and Piso ( r =0.8869, P =0.0001). Conclusions These results suggested somewhat intimate relationships among severity of BOO,prostate volume and symptoms.The increase in detrusor contractility with increasing outlet obstruction suggested a compensatory response to obstruction.