Clinical Application of Videourodynamics in Diagnosis of Lower Urinary Tract Dysfunction

錄影尿動力學診斷下尿路機能障礙的臨床應用

郭漢崇(Hann-Chorng Kuo)

《慈濟醫學雜誌》 13卷1期 (2001/03) Pp. 1-21

https://doi.org/10.6440/TZUCMJ.200103.0001

摘要

在泌尿科病人當中，下尿路症狀極為常見。然而雖然下尿路的功能異常已有相當程度的研究，在臨床診斷上卻不容易，其原因主要是病人常有許多複雜的症狀，使得診斷無法依下尿路症狀而下。事實上排尿是逼尿肌收縮與尿道外括約肌放鬆的一個同步的動作，膀胱與尿道的異常常會合併存在。因此要檢查出下尿路功能異常應該根據排尿時期的各種生理發現，包括逼尿肌收縮力、外括約肌活性、尿流速以及下尿路的解剖學變化。錄影尿動力學檢查即根據影像以及壓力尿流的同步研究以鑑別診斷下尿路症狀。同時檢查病人的膀胱壓力、腹壓、逼尿肌壓力、尿道外括約肌肌電圖、尿流速、以及排尿膀胱尿道攝影，錄影尿動力學檢查可以在各層面提供完全的解剖及功能性資料。對於具有下尿路症狀而且對初步藥物治療效果不良的病人，經由錄影尿動力學檢查可以得到正確的診斷以及治療方針。

關鍵字

錄影尿動力學 ； 下尿路症狀 ； 排尿障礙

並列摘要

Lower urinary tract symptoms (LUTS) are frequently encountered in urological practice. Although lower urinary tract dysfunction has been well explored, diagnosis of LUTS is not easy, mainly because patients often present with a combination of symptoms. Urination is a synchronized action of urethral sphincter relaxation and detrusor contraction. Abnormalities in the bladder and urethra frequently occur in combination. Investigation of lower urinary tract dysfunction should be based on findings of detrusor contractility, external sphincter activity, flow rate, and anatomical changes during voiding. Videourodynamic study is based on the combined studies of image and pressure flow and is used in the differential diagnosis of LUTS. In combination with cystometry, abdominal pressure and detrusor pressure determination, external sphincter electromyography, flow rate, and voiding cystourethrography, videourodynamic study can provide complete information on anatomical and functional abnormalities. Videourodynamic study should be performed in order to obtain a correct diagnosis and treatment when LUTS that are refractory to medical treatment.

並列關鍵字

videourodynamics ； lower urinary tract symptoms ； voiding dysfunction