关键词: 尿动力学, 尿失禁, 压力性, 手术前期

Abstract:

Objective： To investigate the impact of preoperative urodynamic study on the diagnosis and treatment for female patients with clinical diagnosis of stress urinary incontinence by studying their diagnosis and treatment database, and to assess its clinical significance of urodynamic study. Methods: From April 2011 to December 2015, 196 female patients diagnosed clinically with stress urinary incontinence underwent preoperative urodynamics study, after excluding pelvic organ prolapse. The preoperative urodynamic data of these 196 cases were analyzed and the clinical significance of urodynamics on differential diagnosis and treatment for the female patients with stress urinary incontinence was evaluated. Results: In this study, 23 cases (11.73%) changed or amended their diagnoses by the urodynamic study, which were inconsistent with the previous clinical diagnoses concluded by the symptoms, physical examinations, and lab tests. A total of 10 cases underwent a different surgery or conservative treatment instead of the original treatment according to urodynamic study. Of them, 3 were diagnosed as detrusor overactive and undertook conservative treatment; 3 were diagnosed as bladder outlet obstruction plus stress urinary incontinence and were undertaken the transurethral resection of the bladder neck (TURBN) plus tension free vaginal tape (TVT); 2 were diagnosed as bladder outlet obstruction plus stress urinary incontinence and were undertaken TURBN alone; 1 was diagnosed as bladder outlet obstruction plus stress urinary incontinence and was undertaken TURBN plus tension free vaginal tape obturator (TOT); 1 was found no abnormal bladder function turned out to be interstitial cystitis and went for a bladder instillation of drug. The changed treatments avoided the risk of dysuria or residual urine increased after operation due to inappropriate surgical methods. Conclusion: In order to make a correct diagnosis and suitable treatment for female patients with stress urinary incontinences, the preoperative urodynamic study is necessary besides detailed medical history, physical examination, and laboratory tests. With the help of the urodynamic study, the concomitant diseases of patients with stress urinary incontinence may be detected, the individualized treatment regimen can be developed, and more importantly, the inappropriate surgical decision can be avoided.

Key words: Urodynamics, Urinary incontinence, stress, Preoperative period