| Objective: To investigate the characteristics of lower urinary tract symptoms(LUTS)in female patients with bladder outlet obstruction(BOO),and to analyze the etiology and Sonography video urodynamic studies(SVUDS)characteristics of female patients with BOO,thus providing more basis for the early diagnosis of female patients with BOO.Methods: A retrospective analysis was conducted on the clinical data of271 female patients who underwent SVUDS examination for LUTS in the Urology Laboratory of Shaoyang Hospital Affiliated to the University of South China from January 2016 to August 2020 to deeply analyze the clinical features.Based on the fact that BOO can be diagnosed when the maximum urine flow rate is(Qmax)< 12ml/s and detrusor pressure is at the maximum urine flow rate(Pdet.Qmax)> 20 c H2O,the author compared the differences in the incidence of LUTS between BOO and the control group(female patients without BOO),and analyzed the LUTS characteristics of female patients with BOO of two different groups(one is < 50 years old while the other is ≥50 years old).Female patients without BOO during the same period were selected as the control group(group without BOO)to analyze the effects of BOO on bladder post-voiding residual urine(PVR)and bladder wall thickness(BWT),and to analyze the similarities and differences in urodynamics,bladder post-voiding residual urine and bladder wall thickness in female patients with BOO of two different groups(one is < 50 years old while the other is ≥50 years old).Combined with synchronous transperineal ultrasound,the author observed the dynamic changes of urethra and surrounding pelvic floor structure during urination,and analyzed the site and etiology of obstruction in female patients with BOO from two groups of different age.(as mentioned above).Finally,the characteristics of SVUDs in female patients with BOO were summarized.Results: Among the 271 female patients with LUTS,89 cases(32.8%)were in the age group < 50 years old,and 182 cases(67.2%)were in the age group ≥50 years old.The main symptoms of LUTS were urine storage stage(72.1%),and frequency of urine was the most common.Women over 50 years of age had an increased incidence of urinary retention(P=0.004),as well as urinary incontinence(P=0.087)and nocturia(P=0.091).41 female patients with LUTS were diagnosed with BOO,of which 10 cases(24.4%)were < 50 years old and 31 cases(75.6%)were ≥50 years old,with the highest incidence of frequent urination(28/41,68.3%).The incidence of frequent urination,urgent urination,increased nocturia,insufficient urination and dysuria in female patients with BOO was higher than those in female patients with(P <0.01).The incidence of symptoms in the urine storage phase was higher in female patients with BOO than in the urination phase(P < 0.001).The second age group(patients ≥50 years of age)tends to have similiar manifestation(P <0.001),but different in the first age group(patients < 50 years of age)(P=0.684).Compared with BOO and female patients without BOO,the bladder post-voiding residual urine(PVR)increased((98.68 ml±107.70)VS(5.20ml±11.60),P < 0.01),and the bladder wall thickness(BWT)increased((3.62mm±1.49)VS(2.81 mm±0.41),P < 0.01).Urodynamic parameters,bladder post-voiding residual urine,and bladder wall thickness were similar in female patients with BOO aged < 50 years and ≥50 years(P > 0.05).The dynamic characteristics of transperineal ultrasonography of BOO during urination in women with different etiology were different.The etiologies of 41 female patients with BOO were analyzed,including pelvic organ prolapse(POP)in21 cases,dysfunctional voiding(DV)in 9 cases,female urethral stricture(FUS)in 5 cases,primary bladder neck obstruction(PBNO)in 3 cases,and idiopathic bladder outlet obstruction(IBOO)in 3 cases.The urodynamic parameters,bladder post-voiding residual urine and bladder wall thickness of female patients with BOO caused by pelvic organ prolapse(POP)and non-pelvic organ prolapse(POP)were similar(P > 0.05).Conclusion: 1.For female patients with LUTS,the main symptoms are in the urine storage phase,and frequent urinationcan be mostly seen.Besides,women ≥50 years of age are more likely to have LUTS,and their incidence of urinary retention is increasing;2.LUTS of female patients with BOO were mainly characterized by symptoms in the urine storage phase.Compared with the control group(female patients with LUTS without BOO),the incidence of frequent urination,urgent urination,increased nocturia,insufficient urination and dysuria were higher,the residual urine volume of the bladder increased,and the bladder wall thickened.3.Although the etiology of BOO of women is diverse,the etiological composition and urodynamic parameters are similar between different ages.Hence,the qualitative diagnosis,etiology and site of obstruction can be determined by SVUDS. |
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