Abstract：
OBJECTIVE: Female voiding dysfunction with cystocele have been widely studied, but there are no data regarding women without cystoceles. The present study aimed to evaluate the prevalence of detrusor underactivity (DU) and bladder outlet obstruction (BOO) without cystoceles in a large sample size.
METHODS: This was a retrospective cohort study. Between April 1996 and September 2018, 602 neurologically intact women with voiding dysfunction without cystoceles were enrolled. Detrusor pressure (DU) at the maximum flow rate (PdetQmax) <20 cmH2O, maximum flow rate (Qmax) <15 mL/s, and a bladder voiding efficiency <90% and BOO (PdetQmax ≥40 cmH2O and Qmax <12 mL/s) were diagnosed by urodynamic study. Otherwise, a non-DU/BOO diagnosis was made. The prevalence of DU and BOO was the primary outcome. The secondary outcomes were the analyses of the differences between these three groups in objective UDS parameters and subjective questionnaires and bladder diary parameters.
RESULTS: This study included 100 (17%) women with DU, 60 (10%) with BOO, and 442 (73%) with a non-DU/BOO diagnosis. DU increased with age, but BOO decreased as age increased. The women in the DU group were older, had higher parity and pad weights, and lower PdetQmax, maximum urethral closure pressure, and functional profile length than the BOO group. The urodynamic findings did not correlate well to subjective questionnaire parameters. None of the symptoms revealed a significant difference between the groups. The retrospective design was the limitation of the study.
CONCLUSIONS: The prevalence of DU increased with age in women with voiding dysfunction without advanced cystoceles. Conversely, BOO decreased with age. Prevalence intersected in the fourth decade. Diagnosis requires urodynamic evaluation, as subjective symptoms are inconclusive.
METHODS: This was a retrospective cohort study. Between April 1996 and September 2018, 602 neurologically intact women with voiding dysfunction without cystoceles were enrolled. Detrusor pressure (DU) at the maximum flow rate (PdetQmax) <20 cmH2O, maximum flow rate (Qmax) <15 mL/s, and a bladder voiding efficiency <90% and BOO (PdetQmax ≥40 cmH2O and Qmax <12 mL/s) were diagnosed by urodynamic study. Otherwise, a non-DU/BOO diagnosis was made. The prevalence of DU and BOO was the primary outcome. The secondary outcomes were the analyses of the differences between these three groups in objective UDS parameters and subjective questionnaires and bladder diary parameters.
RESULTS: This study included 100 (17%) women with DU, 60 (10%) with BOO, and 442 (73%) with a non-DU/BOO diagnosis. DU increased with age, but BOO decreased as age increased. The women in the DU group were older, had higher parity and pad weights, and lower PdetQmax, maximum urethral closure pressure, and functional profile length than the BOO group. The urodynamic findings did not correlate well to subjective questionnaire parameters. None of the symptoms revealed a significant difference between the groups. The retrospective design was the limitation of the study.
CONCLUSIONS: The prevalence of DU increased with age in women with voiding dysfunction without advanced cystoceles. Conversely, BOO decreased with age. Prevalence intersected in the fourth decade. Diagnosis requires urodynamic evaluation, as subjective symptoms are inconclusive.
摘要：
目的：女性排尿障碍伴膀胱膨出已被广泛研究，但是没有关于女性没有囊肿的数据。本研究旨在评估大样本量的逼尿肌活动不足（DU）和膀胱出口梗阻（BOO）的患病率。
方法：这是一项回顾性队列研究。在1996年4月至2018年9月之间，纳入了602名神经系统完整的排尿功能障碍且无囊肿的女性。在最大流量(PdetQmax)<20cmH2O时,最大流速(Qmax)<15mL/s,通过尿动力学研究诊断出膀胱排尿效率<90％和BOO（PdetQmax≥40cmH2O和Qmax<12mL/s）。否则,进行了非DU/BOO诊断。DU和BOO的患病率是主要结果。次要结果是分析这三组在客观UDS参数和主观问卷以及膀胱日记参数方面的差异。
结果：这项研究包括100名（17%）患有DU的女性，60（10%）与BOO，442例（73%）诊断为非DU/BOO。DU随年龄增加,但是BOO随着年龄的增长而下降。DU组的女性年龄较大，具有较高的奇偶校验和垫重量，和较低的PdetQmax，最大尿道闭合压力,和功能剖面长度比BOO组。尿动力学检查结果与主观问卷参数没有很好的相关性。所有症状均未显示两组之间的显着差异。回顾性设计是该研究的局限性。
结论：在没有晚期囊肿的排尿功能障碍的女性中，DU的患病率随年龄增加而增加。相反，BOO随年龄增长而下降。患病率在第四个十年相交。诊断需要尿动力学评估,因为主观症状尚无定论。
方法：这是一项回顾性队列研究。在1996年4月至2018年9月之间，纳入了602名神经系统完整的排尿功能障碍且无囊肿的女性。在最大流量(PdetQmax)<20cmH2O时,最大流速(Qmax)<15mL/s,通过尿动力学研究诊断出膀胱排尿效率<90％和BOO（PdetQmax≥40cmH2O和Qmax<12mL/s）。否则,进行了非DU/BOO诊断。DU和BOO的患病率是主要结果。次要结果是分析这三组在客观UDS参数和主观问卷以及膀胱日记参数方面的差异。
结果：这项研究包括100名（17%）患有DU的女性，60（10%）与BOO，442例（73%）诊断为非DU/BOO。DU随年龄增加,但是BOO随着年龄的增长而下降。DU组的女性年龄较大，具有较高的奇偶校验和垫重量，和较低的PdetQmax，最大尿道闭合压力,和功能剖面长度比BOO组。尿动力学检查结果与主观问卷参数没有很好的相关性。所有症状均未显示两组之间的显着差异。回顾性设计是该研究的局限性。
结论：在没有晚期囊肿的排尿功能障碍的女性中，DU的患病率随年龄增加而增加。相反，BOO随年龄增长而下降。患病率在第四个十年相交。诊断需要尿动力学评估,因为主观症状尚无定论。
