男性膀胱过度活动症的尿动力学分型及临床疗效随访

doi:10.19723/j.issn.1671-167X.2019.06.012

Abstract

Abstract:

Objective: To introduce a urodynamic classification of male patients with symptoms of overactive bladder (OAB) and discuss its clinical significance in practice.Methods: From January 2015 to January 2017, there were 181 male patients from Peking University People’s Hospital who were diagnosed clinically with OAB and underwent preoperative urodynamic test. Finally 126 male patients were enrolled in the research. Male OAB patients could be stratified into four groups based on the chief complaints (whether or not presenting urgency) and the results of urodynamic test (whether or not presenting detrusor overactivity and the ability to stop the involuntary contraction). The contents of this follow-up study included the basic information, the preoperative and postoperative scores of the OAB symptom score (OABSS), the preoperative and postoperative scores of the international prostate symptom score (IPSS), and the amount of the concomitant diseases.Results: According to the classification, the amounts of the four types of OAB patients were 32 (25.40%) for type Ⅰ, 27 (21.43%) for type Ⅱ, 59 (46.83%) for type Ⅲ, and 8 (6.35%) for type Ⅳ, respectively. The data of their heights showed no statistical significance (P>0.05). The ages, weights and the amount of the concomitant diseases of type Ⅳ were obviously higher than those of the other three types (P<0.05). And the ages, weights and the amount of the concomitant diseases of the other three types had shown no statistical significance (P>0.05). The improvement of the OABSS and IPSS scores of the type Ⅳ were obviously inferior to the other three types (P<0.05). The improvements of the OABSS and IPSS scores of type Ⅲ were obviously higher than those of the other three (P<0.05). The discrepancy of the OABSS and IPSS scores of type Ⅰ and type Ⅱ had shown no statistical significance (P>0.05).Conclusion: Type Ⅳ has the worst outcome and type Ⅲ has the best among the four types of OAB. And this classification system will certainly have a profound significance in guiding and directing our clinical diagnosis and treatments, and evaluating the prognosis of the patients with OAB.

Key words: Male, Overactive bladder, Urination disorders, Urodynamics

CLC Number:

R694

Tao WANG,Ke-xin XU,Wei-yu ZHANG,Hao HU,Xiao-wei ZHANG,Huan-rui WANG,Xian-hui LIU,Jing-wen CHEN,Xiao-peng ZHANG. Urodynamic classification of male patients with symptoms of overactive bladder and the outcome classification[J].Journal of Peking University(Health Sciences), 2019, 51(6): 1048-1051.

Figures/Tables 4

Table 1

Figure 1

Table 2

Univeriate analysis of information about the four types of male OAB patients"

Variables	Type Ⅰ	Type Ⅱ	Type Ⅲ	Type Ⅳ	Univariate analysis (P values)
Age/years, $x ?$ ±s	69.50±13.92	69.51±8.05	68.75±9.29	78.50±9.20	0.033
Height/cm, $x ?$ ±s	171.38±5.98	171.70±6.00	171.22±5.54	173.63±4.94	0.125
Weight/kg, $x ?$ ±s	69.30±6.19	68.43±5.68	68.93±8.83	73.50±7.52	0.030
OABSS^*, $x ?$ ±s	4.62±2.23	4.18±2.45	6.07±3.33	2.75±1.77	<0.001
IPSS^*, $x ?$ ±s	14.72±6.71	14.26±8.00	16.13±8.25	7.45±4.70	0.036
Concomitant disease, $x ?$ ±s	2.25±1.11	2.22±1.09	2.16±1.15	4.25±2.60	<0.001

Table 2

Table 3

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Types	Symptoms	Urodynamic test
Type Ⅰ	Urgency, no incontinence	No DO, no incontinence
Type Ⅱ	Urgency, no incontinence	DO, no incontinence
Type Ⅲ	Urgency, incontinence	DO, incontinence
Type Ⅳ	No urgency, incontinence	DO, incontinence

Variables	OR	95%CI	P values
Age	1.76	1.10-4.21	0.036
Weight	1.99	1.21-3.09	0.039
OABSS^*	3.55	1.57-8.23	0.014
IPSS^*	1.37	1.04-4.25	0.045
Concomitant disease	2.98	2.01-7.36	0.016

Urodynamic classification of male patients with symptoms of overactive bladder and the outcome classification

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