良性前列腺增生并发急性尿潴留患者的逼尿肌收缩功能

doi:10.6040/j.issn.1671-7554.0.2017.1183

Abstract

Abstract: Objective To elucidate the urodynamic and clinical characteristics of benign prostate hyperplasia(BPH)patients complicated by acute urinary retention(AUR), specially focusing on their detrusor contraction function. Methods The urodynamic parameters and clinical characteristics of 264 BPH patients from Aug. 2014 to Mar. 2017 were analyzed retrospectively. The patients were divided into AUR group(n=99)and non-AUR group(n=165). Urodynamic study was performed 7-10 days after the urinary catherization for AUR patients. Age, prostate-specific antige(PSA)level, prostate volume(PV), and urodynamic parameters in the two groups were compared. Results Age and PSA level of AUR patients were significantly higher than those of non-AUR patients(P<0.05). Maximum flow rate, voided volume, bladder volume at first desire and strong desire, and bladder compliance were decreased in AUR patients than those in non-AUR patients(all P<0.05). The percentage of patients with Schaefer obstruction grade IV or higher was greater in AUR group than that in non-AUR group(P<0.05). In both groups, bladder contraction index(BCI)and maximum Watts factor(W_max)were increased with the rising of obstruction grade; however, there was no significantly statistical difference for these two indexes. Multivariate Logistic regression analysis showed that obstruction 山东大学学报 (医学版)56卷3期 -王文振,等. 良性前列腺增生并发急性尿潴留患者的逼尿肌收缩功能 \=-grades III, IV and VI were risk factors for predicting the development of AUR. Conclusion Obstruction severity rather than the impairment of detrusor contractility is closely related with the occurrence of AUR in BPH patients.

Key words: Benign prostate hyperplasia, Acute urinary retention, Urodynamics, Prostate-specific antigen, Bladder contraction index, Watts factor

CLC Number:

R443+.8

WANG Wenzhen, LIU Yuqiang, ZU Shulu, ZHANG Xiulin, ZHANG Chanjuan, SHAO Guangfeng, YU Yang, WANG Shaoyong. Detrusor contractility in patients with benign prostate hyperplasia combined with acute urinary retention[J].Journal of Shandong University (Health Sciences), 2018, 56(3): 66-71.

References

[1] Berry SJ, Coffey DS, Walsh PC, et al. The development of human benign prostatic hyperplasia with age[J]. J Urol, 1984, 132(3):474-479.
[2] Garraway WM, Collins GN, Lee RJ. High prevalence of benign prostatic hypertrophy in the community[J]. Lancet, 1991, 338(8765):469-471.
[3] Powell PH, Smith PJ, Feneley RC. The identification of patients at risk from acute retention[J]. Br J Urol, 1980, 52(6): 520-522.
[4] Jacobsen SJ, Jacobson DJ, Girman CJ, et al. Natural history of prostatism: risk factors for acute urinary retention[J]. J Urol, 1997, 158(2): 481-487.
[5] Tuncel A, Uzun B, Eruyar T, et al. Do prostatic infarction, prostatic inflammation and prostate morphology play a role in acute urinary retention[J]. Eur Urol, 2005, 48(2): 277-283, 283-284.
[6] 廖利民. 尿动力学技术规范——介绍国际尿控协会标准化报告[J].中国康复理论与实践, 2005,11(11): 875-878.
[7] 张一川,何乐业,龙智,等.前列腺增生症患者急性尿潴留发生的临床特点[J]. 中南大学学报(医学版), 2012, 37(3): 300-304. ZHANG Yichuan, HE Leye, LONG Zhi, et al. Clinical features of acute urine retention in patients with benign prostate hyperplasia[J]. J Cent South Univ(Med Sci), 2012, 37(3): 300-304.
[8] Roehrborn CG, Malice M, Cook TJ, et al. Clinical predictors of spontaneous acute urinary retention in men with LUTS and clinical BPH: a comprehensive analysis of the pooled placebo groups of several large clinical trials[J]. Urology, 2001, 58(2): 210-216.
[9] Roehrborn CG. The epidemiology of acute urinary retention in benign prostatic hyperplasia[J]. Rev Urol, 2001, 3(4): 187-192.
[10] Marberger MJ, Andersen JT, Nickel JC, et al. Prostate volume and serum prostate-specific antigen as predictors of acute urinary retention. Combined experience from three large multinational placebo-controlled trials[J]. Eur Urol, 2000, 38(5): 563-568.
[11] 谢克基,廖土明,李涛,等.良性前列腺增生并急性尿潴留后的逼尿肌功能评估及其临床意义[J]. 中华泌尿外科杂志, 2006, 27(5): 311-313. XIE Keji, LIAO Tuming, LI Tao, et al. Evaluation of detrusor function and its clinical significance in patient with acute urinary retention secondary to benign prostatic hyperlasia[J]. Chin J Urol, 2006, 27(5): 311-313.
[12] Dubey D, Kumar A, Kapoor R, et al. Acute urinary retention: defining the need and timing for pressure-flow studies[J]. BJU Int, 2001, 88(3): 178-182.
[13] 谢涛,谢群,韩耕宇,等.前列腺增生并急性尿潴留行尿动力学检查时机的选择[J].医学临床研究, 2016, 33(7): 1379-1381.
[14] Roehrborn CG, Bruskewitz R, Nickel GC, et al. Urinary retention in patients with BPH treated with finasteride or placebo over 4 years. Characterization of patients and ultimate outcomes. The PLESS Study Group[J]. Eur Urol, 2000, 37(5): 528-536.
[15] Miyashita H, Kojima M, Miki T. Ultrasonic measurement of bladder weight as a possible predictor of acute urinary retention in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia[J]. Ultrasound Med Biol, 2002, 28(8): 985-990.
[16] 卢根生,格次,宋波,等.不稳定膀胱逼尿肌兴奋性及收缩性改变的实验研究[J].第三军医大学学报, 2003, 25(24): 2229-2231. LU Gensheng, GE Ci, SONG Bo, et al. Changes of excitability and contractility in detrusor instability[J]. ACTA Academiae Medicinae Militaris Tertiae, 2003, 25(24): 2229-2231.
[17] CHS B, Ribeiro WO, Hemerly TS, et al. Increased detrusor collagen is associated with detrusor overactivity and decreased bladder compliance in men with benign prostatic obstruction[J]. Prostate Int, 2017, 5(2): 70-74.
[18] He LY, Zhang YC, He JL, et al. The effect of immediate surgical bipolar plasmakinetic transurethral resection of the prostate on prostatic hyperplasia with acute urinary retention[J]. Asian J Androl, 2016, 18(1): 134-139.
[19] Oelke M, Rademakers KL, van Koeveringe G A. Detrusor contraction power parameters(BCI and W_max)rise with increasing bladder outlet obstruction grade in men with lower urinary tract symptoms: results from a urodynamic database analysis[J]. World J Urol, 2014, 32(5): 1177-1183.
[20] Oelke M, Höfner K, Wiese B, et al. Increase in detrusor wall thickness indicates bladder outlet obstruction(BOO)in men[J]. World J Urol, 2002, 19(6): 443-452.
[21] Manieri C, Carter SS, Romano G, et al. The diagnosis of bladder outlet obstruction in men by ultrasound measurement of bladder wall thickness[J]. J Urol, 1998, 159(3): 761-765.

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed

Comments

Recommended 0

No Suggested Reading articles found!

Detrusor contractility in patients with benign prostate hyperplasia combined with acute urinary retention

PDF (PC)

Abstract

Cite this article

share this article

References

Related Articles 4

Metrics

Comments

Recommended 0

[1]	XU Zhen, DIAO Tongxiang, ZANG Zhenjie, SHAO Dingchang, ZHANG Qi, SUN Dingqi, FU Qiang. Value of isoform［-2］proprostate-specific antigen and its derivatives in the diagnosis of prostate cancer [J]. Journal of Shandong University (Health Sciences), 2022, 60(6): 51-56.
[2]	QIAO Yu-hua, ZUO Shu-sen, LI Do-shun, HAO Qiang. Clinical effective observation of 980/1 470 nm dual-wavelength laser transurethral prostatectomy in the treatment of benignprostatic hyperplasia [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(S1): 85-87.
[3]	ZHAN Lilong， XIA Qinghua, JIN Xunbo， XIONG Hui. Prostate volume, intravesical prostatic protrusion and bladder-urethra angle of prostate as predictors of acute urinary retention in benign prostate hyperplasia [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2010, 48(5): 113-115.
[4]	JI Kai,WANG Xiao-ling,XU Ai-hui,HU Zhi-min,YUAN Hui-qing. Targeting expression of TAT－EGFP driven by the prostate specific antigen promoter [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2008, 46(8): 742-746.