The Research Of Urodynamic Examination In The Diagnosis Of Patients With Female Bladder Outlet Obstruction

Objects: To investigate parameters of urodynamic examinations in the diagnosis of patients with female bladder outlet obstruction (FBOO).Methods: 105 cases of patients with FBOO by clinical diagnosis received conventional urodynamic examinations including pressure-flow studies, urethral pressure profilometry, and micturitional urethral pressure profilometry by Menueturodynamic instrument of Dantec company. Parameters--bladder compliance (BC),flow delay (FD), Qura maximum (Qmax), pressure of detrusor open (Pdet.open), pressure of detrusor maximum (Pdet.max), P-Q plot level of obstruction, the number of urethral pressure grads (UPG) in MUPP, automatic or evoked uninhibited contractive wave in static stage, the changes of electromyogram in voiding were observed. Patients were divided into four groups according to 40 years old below, 40-50 years old, 50-60 years old, 60 years old above. Patients with stress incontinence by clinical diagnosis and normal healthy women are compared. The data were analyzed by t test. 12 patients underwent transurethral resection of bladder neck and received pathologic examinations in 105 patients.Results: By comparison,Qmax, FD, Pdet.max, Pdet.opem decreased and UPG, BC increased in P-Q plot level 0- I ;Qmax, BCU FD decreased and Pdet.max, Pdet.open, UPG increased in P-Q plot level II-V.All data were analyzed by t test and the numbers of t were less than 0.01. Automatic or evoked uninhibited contractive waves in static stage occurred in 15 cases, Electromyograms in 18 cases of 105 patients were active and strengthened in voiding. 12 pathologic examinations with transurethral resection of bladder neck showed proliferation of fibrous tissue and smooth muscle cells , colloid denaturationx vasodilatation and congestion a littlechronic inflammatory cellular infiltration.Conclusions: Qmax, BC, FD, Pdet.max, Pdet.open, P-Q plot, UPG and the changes of electromyogram in voiding have great significance. MUPP deserves more promotion in clinic due to its high reproduction in identifying the location of FBOO, especially on condition that detrusor is damaged and lack of compensation ,P-Q plot can not identify the presence of obstruction. The cases of active electromyogram in voiding supply powerful basis in diagnosing detrusor-sphincter dyssynergia.