Male sex is a risk factor for detrusor pressure jeopardising the upper urinary tract in patients with spinal cord injury.

IF 4.4 2区 医学 Q1 UROLOGY & NEPHROLOGY
Veronika Birkhäuser,Collene E Anderson,Marko Kozomara,Martin W G Brinkhof,Oliver Gross,Lorenz Leitner,Martina D Liechti,Ulrich Mehnert,Lara Stächele,Thomas M Kessler
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Abstract

OBJECTIVE To evaluate sex differences in maximum storage detrusor pressure (Pdetmax storage), focusing on Pdetmax storage ≥40 cmH2O, an established risk factor for upper urinary tract damage, within the first year after spinal cord injury (SCI). PATIENTS AND METHODS A cohort of patients with neurogenic lower urinary tract dysfunction due to acute traumatic or ischaemic SCI, managed according to the European Association of Urology Guidelines on Neuro-Urology, prospectively underwent urodynamic investigations at 1, 3, 6 and 12 months after SCI at a university SCI centre. Pearson's chi-squared tests and multivariable regression analyses were used to compare outcomes between females and males. RESULTS Of 97 patients, 34% were female. Within the first year after SCI, 9% of females presented with a Pdetmax storage ≥40 cmH2O, compared to 55% of males (P < 0.001). Females had lower Pdetmax storage than males, with a grand mean (standard deviation [SD]) of 13 (9) vs 30 (20) cmH2O (coefficient = 18 cmH2O, 95% confidence interval [CI] 13-24 cmH2O; P < 0.001). Females also had lower detrusor overactivity leak-point pressure (DOLPP) than males, with a grand mean (SD) of 15 (4) vs 35 (21) cmH2O (coefficient = 20 cmH2O, 95% CI 11-29 cmH2O; P < 0.001). The cumulative incidence of antimuscarinic therapy and reported urinary incontinence was similar between sexes (female vs male: 55% vs 70%, P = 0.12; 53% vs 43%, P = 0.42, respectively). CONCLUSIONS Females rarely reached a Pdetmax storage ≥40 cmH2O during the first year after SCI and had lower Pdetmax storage and DOLPP than males. However, the prevalence of urinary incontinence was similar between the sexes, suggesting the need for a more sex-tailored approach to patient management.
男性是脊髓损伤患者逼尿肌压力危及上尿路的危险因素。
目的评价脊髓损伤(SCI)后一年内最大储压逼尿肌压力(Pdetmax storage)的性别差异,重点关注Pdetmax storage≥40 cmH2O,这是上尿路损伤的已知危险因素。患者和方法:一组急性外伤性或缺血性脊髓损伤导致的神经源性下尿路功能障碍患者,根据欧洲泌尿外科协会神经-泌尿外科指南,在一所大学脊髓损伤中心前瞻性地进行了脊髓损伤后1、3、6和12个月的尿动力学调查。使用Pearson卡方检验和多变量回归分析比较男女之间的结果。结果97例患者中,女性占34%。在脊髓损伤后的第一年,9%的女性表现为Pdetmax存储≥40 cmH2O,而男性为55% (P < 0.001)。女性的Pdetmax存储量低于男性,大平均值(标准差[SD])为13(9)比30 (20)cmH2O(系数= 18 cmH2O, 95%置信区间[CI] 13-24 cmH2O; P < 0.001)。女性的逼尿肌过度活动漏点压力(DOLPP)也低于男性,大平均值(SD)为15(4)比35 (21)cmH2O(系数= 20 cmH2O, 95% CI 11-29 cmH2O; P < 0.001)。抗毒蕈碱治疗和报告尿失禁的累积发生率在两性之间相似(女性vs男性:55% vs 70%, P = 0.12; 53% vs 43%, P = 0.42)。结论女性在脊髓损伤后1年内Pdetmax storage≥40 cmH2O的患者极少,且Pdetmax storage和DOLPP均低于男性。然而,尿失禁的患病率在两性之间是相似的,这表明需要一种更适合性别的患者管理方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BJU International
BJU International 医学-泌尿学与肾脏学
CiteScore
9.10
自引率
4.40%
发文量
262
审稿时长
1 months
期刊介绍: BJUI is one of the most highly respected medical journals in the world, with a truly international range of published papers and appeal. Every issue gives invaluable practical information in the form of original articles, reviews, comments, surgical education articles, and translational science articles in the field of urology. BJUI employs topical sections, and is in full colour, making it easier to browse or search for something specific.
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