Ju Hun Ahn, Joon Chul Kim, Jin Bong Choi, Jun Sung Koh, Young Kyu Han, Seong Joo Yang, Kang Jun Cho
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引用次数: 0
Abstract
Purpose: Overactive bladder (OAB) symptoms may improve following surgical correction of cystocele. This study aimed to evaluate changes in urgency, the primary symptom of OAB, and identify factors associated with improvement in urgency after surgical treatment for cystocele.
Methods: We conducted a retrospective analysis of medical records for patients who underwent surgical treatment for cystocele and had preoperative urgency measuring ≥3 on a 5-point urinary sensation scale. Patients were categorized into 2 groups based on their urgency status 3 months postsurgery: those with improved urgency and those without improvement. Improvement was defined as a reduction of 2 or more points on the scale following surgery. We compared preoperative clinical and urodynamic factors between the 2 groups.
Results: A total of 137 patients were included in the study, with 98 (71.5%) showing improvement in urgency symptoms after surgery. The improved group had a significantly higher prevalence of preoperative urgency urinary incontinence (UUI) (62.2% vs. 30.8%, P=0.001) and bladder outlet obstruction (43.9% vs. 20.5%, P=0.011) compared to the nonimproved group. Urodynamic evaluations indicated that the detrusor pressure at maximum flow rate (PdetQmax) was significantly higher in the improved group than in the nonimproved group (P=0.004). Multivariate logistic regression analysis identified preoperative UUI, higher PdetQmax, and lower vaginal parity as independent predictors of improvement in urgency postoperatively.
Conclusion: Preoperative UUI, higher PdetQmax, and lower vaginal parity were significant predictors of postoperative improvement in urgency. Both clinical and urodynamic factors may help identify patients with cystocele and preoperative urgency who are most likely to benefit from anatomical correction.
目的：膀胱过动症（OAB）的症状可在膀胱膨出手术矫正后得到改善。本研究旨在评估急迫性（OAB的主要症状）的变化，并确定胆囊膨出手术治疗后急迫性改善的相关因素。方法：回顾性分析接受膀胱膨出手术治疗且术前尿急（5分尿感量表）≥3分的患者病历。根据患者术后3个月的急症状况将患者分为两组：急症改善组和无改善组。改善被定义为术后评分降低2分或以上。比较两组患者术前临床及尿动力学因素。结果：共纳入137例患者，其中98例（71.5%）术后急症症状改善。改良组术前急迫性尿失禁（UUI）发生率（62.2% vs. 30.8%， P=0.001）和膀胱出口梗阻发生率（43.9% vs. 20.5%， P=0.011）明显高于未改良组。尿动力学评估显示，改良组最大流速下逼尿肌压力（PdetQmax）显著高于未改良组（P=0.004）。多因素logistic回归分析发现术前UUI、较高的PdetQmax和较低的阴道胎次是术后急症改善的独立预测因素。结论：术前UUI、较高的PdetQmax和较低的阴道胎次是术后急症改善的重要预测因素。临床和尿动力学因素都可以帮助确定有膀胱膨出和术前急症的患者，他们最有可能从解剖矫正中获益。
期刊介绍：
The International Neurourology Journal (Int Neurourol J, INJ) is a quarterly international journal that publishes high-quality research papers that provide the most significant and promising achievements in the fields of clinical neurourology and fundamental science. Specifically, fundamental science includes the most influential research papers from all fields of science and technology, revolutionizing what physicians and researchers practicing the art of neurourology worldwide know. Thus, we welcome valuable basic research articles to introduce cutting-edge translational research of fundamental sciences to clinical neurourology. In the editorials, urologists will present their perspectives on these articles. The original mission statement of the INJ was published on October 12, 1997.
INJ provides authors a fast review of their work and makes a decision in an average of three to four weeks of receiving submissions. If accepted, articles are posted online in fully citable form. Supplementary issues will be published interim to quarterlies, as necessary, to fully allow berth to accept and publish relevant articles.
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