原发性膀胱颈梗阻/原发性膀胱颈协同失调的诊断与治疗现状  

Diagnosis and treatment of primary bladder neck obstruction or primary bladder neck dyssynergia

作　　者：覃艳 吴栗洋 张鹏[1] 胡小鹏[1] Qin Yan;Wu Liyang;Zhang Peng;Hu Xiaopeng(Department of Urology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院泌尿外科,北京100020

出　　处：《首都医科大学学报》2021年第5期868-873,共6页Journal of Capital Medical University

摘　　要：原发性膀胱颈梗阻(primary bladder neck obstruction,PBNO)/原发性膀胱颈协同失调(primary bladder neck dyssynergia,PBND)是一组病因不明的膀胱颈梗阻综合征,临床表现为排尿期症状(排尿费力、尿踌躇、尿流变细、排空不全等)、储尿期症状(尿频、尿急、尿失禁、夜尿等)或两者同时存在。影像尿动力检查(video-urodynamic study,VUDS)是诊断PBNO/PBND的金标准,PBNO/PBND特征为高压低流的排尿模式,在影像透视下可见膀胱颈未开放或开放不全。轻症患者可采取观察、药物治疗及间歇清洁自家导尿等措施进行保守治疗,保守治疗无效的患者应行经尿道膀胱颈电切术。为进一步了解PBNO/PBND及其进展,本文就相关研究进展进行综述。Primary bladder neck obstruction or primary bladder neck dyssynergia(PBNO/PBND)is a set of specific bladder neck obstruction syndrome,the precise cause of PBNO/PBND has not been clearly elucidated,PBNO/PBND may present with a variety of symptoms,including voiding symptoms(dysuria,hesitation,straining,incomplete emptying),storage symptoms(frequency,urgency,urinary incontinence,nocturia)or a combination of both.It is considered that video-urodynamic study(VUDS)is the gold standard for the diagnosis of this disease,PBNO/PBND is a video urodynamic diagnosis whose hallmarks include high-pressure low-flow voiding,and radiographic evidence of bladder neck is not open or incomplete.Treatment for some patients with slight symptoms can choose observation,pharmacological treatment and clean intermittent self-catheterization,for patients who failed to receive conservative treatment should be performed transurethral bladder neck incision.To further understand PBNO/PBND and its progress,this article reviews the relevant research progress.

关 键 词：原发性膀胱颈梗阻 原发性膀胱颈协同失调 影像尿动力学 经尿道膀胱颈电切术 

分 类 号：R69[医药卫生—泌尿科学]