前列腺增生症膀胱出口梗阻类型对剩余尿量的影响

目的：探讨前列腺增生症（BPH）所致膀胱出口梗阻（BOO）类型对膀胱排空及剩余尿量的影响。方法：根据直线被动尿道阻力关系（直线PURR）特点，从既往行尿动力学检查的BPH患者中选择68例，其中45例诊断为压迫型梗阻（压迫组），23例为狭窄型梗阻（狭窄组），所有患者逼尿肌收缩功能良好。对两组平均剩余尿量等尿动力学指标以及急性尿潴留发病率进行比较。结果：压迫组的剩余尿量显著高于狭窄组（P＜0．01）；压迫组15例（33．3％）、狭窄组1例（4．3％）有急性尿潴留病史，差异有极显著性意义（P＜0．01）；两组平均年龄、最大尿流率、最大逼尿肌压和梗阻程度的差异均无显著性意义。结论：BOO类型对膀胱排空障碍及剩余尿的产生有明显影响，压迫型梗阻患者易发生尿潴留。剩余尿量不能作为评价BPH患者逼尿肌功能和治疗预后的可靠指标。

Effect of obstructive type on residual urine volume in BPH

Purpose:To investigate the effect of obstructive type on residual urine volume in BPH.Method:According to the characteristics of linear passive urethral resistance relation (LinPURR), 68 cases of BPH with good detrusor contractility were stratified into two groups:45 compressive obstruction and 23 constrictive obstruction.Residual urine and other urodynamic results, morbidity of urinary retention were compared between two groups.Results:Statistically, the average volume of residual urine was more in the compressive group (P< 0.01).15( 33.3%) cases in compressive group, but only 1( 4.3%) in constrictive group had urinary retention history, the difference was significant (P< 0.01).There was no statistical difference in years, Q max, Pdetmax or degree of BOO between two groups.Conclusions:The types of BOO have great effect on bladder voiding and residual urine, patients with compressive obstruction are more likely to suffer from urinary retention.Residual urine volume cannot be regard as a reliable index for detrusor function or therapeutic prognosis in BPH.