배뇨곤란을 보이는 뇌질환 환자의 요역동학적 고찰
Urodynamic Evaluation in Patients with Voiding Dysfunction Associated
우도식, 이길호, 김형지,
소속 상세정보
우도식 ( )
단국대학교
이길호 ( )
단국대학교
김형지 ( )
단국대학교
KMID : 0358319970380040404
Abstract
Typical urodynamic findings in patients with intracranial lesion are uninhibited bladder contraction (detrusor hyperreflexia) with coordinated sphincter activity. However, the findings of urodynamic study are variable and dependent on the degree
and
site of intracranial lesion, the presence of underlying disease and the adequacy of initial management of voiding problems from onset of the neurologic symptoms.
In this study, we tried to investigate the urodynamic findings in 40 patients who had intracranial lesions(traumatic or organic brain disease) with voiding dysfunction.
@ES The following results were obtained.
@EN 1. Out of all 40 patients, 35 had organic brain disease such as infarct, intracranial hemorrhage, or Parkinsonism etc. and 5 had traumatic brain disease.
2. Among 40 patients, detrusor pressure in 29(72.5%), detrusor areflexia in 9(22.5%) and normal detrusor pressure in 2 (5%).
3. In 29 cases of detrusor hyperreflexia, there was no history of urinary retention, but in 12 cases with history of urinary retention, 9 cases(75%) revealed as detrusor areflexia.
4. No specific cause except the history of urinary retention was considerable in 8 of 9 patients with detrusor areflexia.
In our study, urodynamic findings in the patients with intracranial lesion who had voiding dysfunction revealed nine cases(22.5%) of detrusor areflexia and the presumptive cause of detrusor areflexia is considered to previous urinary retention.
Therefore, highly individualized and programmed early urologic involvement on the basis basis of urodynamic study is recommended for the prevention of urinary retention in initial "cerebral shock" stage of cerebrovascular accident and when
detrusor
areflexia had been developed, intensive management for the removal of the residual urine is necessary.
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