압력요속검사로 정의한 여성 방광출구폐색을 진단하는 인자에 대한 연구
Predictive Factors for Female Bladder Outlet Obstruction Defined by Pressure-Flow Study
하승범, 김성수, 이승태, 민경은, 정성진, 홍성규, 변석수, 이상은,
소속 상세정보
하승범 ( Ha Seung-Beom )
서울대학교 의과대학 분당서울대학교병원 비뇨기과학교실
김성수 ( Kim Seong-Soo )
서울특별시 동부병원 비뇨기과
이승태 ( Lee Seung-Tae )
국립경찰병원 비뇨기과
민경은 ( Min Kyeong-Eun )
경희대학교 의과대학 동서신의학병원 비뇨기과학교실
정성진 ( Jeong Seong-Jin )
서울대학교 의과대학 분당서울대학교병원 비뇨기과학교실
홍성규 ( Hong Sung-Kyu )
서울대학교 의과대학 분당서울대학교병원 비뇨기과학교실
변석수 ( Byun Seok-Soo )
서울대학교 의과대학 분당서울대학교병원 비뇨기과학교실
이상은 ( Lee Sang-Eun )
서울대학교 의과대학 분당서울대학교병원 비뇨기과학교실
KMID : 0358320090500090848
Abstract
Purpose: We investigated pre-urodynamic study parameters of bladder outlet obstruction (BOO) defined by pressure-flow study (PFS) in female patients without anatomical obstruction.
Materials and Methods: The cohort of this study consisted of 320 women who did not have anatomical BOO in whom urodynamic study was conducted for lower urinary tract symptoms (LUTS). BOO was defined when the PFS maximal flow rate (Qmax) was ≤12 ml/sec and Pdet Qmax was ≥25 cmH2O. The main outcomes were the incidence of BOO and its predictive factors in our cohort.
Results: Of the total patients, 39 (12.2%) were diagnosed with BOO in the PFS. Free Qmax and maximal voided volume (MVV) were significant predictors of BOO (p＜0.001, p=0.011, respectively) in the multivariate logistic regression. When free Qmax was set to ≤15 ml/sec, its sensitivity and specificity predicting BOO were 82% and 72%, respectively; when MVV was set to ≤350 ml, its values were 71% and 46%, respectively. However, the positive predictive values (PPVs) of free Qmax and MVV were low (34.4% and 28.2%, respectively), whereas the negative predictive values (NPVs) of these parameters were relatively high (96.5% and 91.2%, respectively).
Conclusions: Factors predicting BOO defined by PFS in female patients complaining LUTS without anatomical obstruction were free Qmax and MVV. The PPV of these factors was low, and the NPV was high. Therefore, if free Qmax is ＞15 ml/sec or MVV is ＞350 ml, PFS may be not essential. On the contrary, if free Qmax and MVV are below these levels, PFS may be indicated to evaluate the presence of BOO.
키워드
Urinary bladder neck obstruction;Urodynamics;Female
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