女性尿失禁患者における尿流動態検査の必要性

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1)臨床的に真性腹圧性尿失禁と診断した患者52例の内,尿流動態検査で診断一致した例は37例,排尿筋不安定症と診断した患者は8例であった.2)切迫性尿失禁(不安定膀胱)と診断した患者19例の内,尿流動態検査で排尿筋の不随意性収縮のなかった症例は6例であった.3)真性腹圧性尿失禁と不安定膀胱の混合型と診断した25例の内,5例のみが尿流動態検査による診断と一致していた.以上のように,愁訴,身体所見,臨床所見からと尿流動態検査とから診断した尿失禁型との間に差を認めたTo determine the type of urinary incontinence in 96 female incontinent patients, we performed a comparative study between the clinical evaluation and the results of urodynamic studies. Their complaints, physical examination, laboratory examinations including routine urological X-ray and ultrasonic studies, revealed that 15 to 30% of the patients had another type of incontinence than those with stress incontinence, urge incontinence and those in whom diagnosis was made from urodynamic studies. Urodynamic studies disclosed that another urinary incontinence type was observed in 7 to 18% of the patients, who were not improved in spite of treatment which was required because of their complaints and physical examination. Our findings showed that urinary incontinence could not be classified according to the frequency of urination or vesical volume. Urodynamic studies may be essential in female patients with urinary incontinence scheduled to have an operation or for whom initial treatment was unsuccessful.

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福井準之助
聖路加国際病院泌尿器科

女性尿失禁患者における尿流動態検査の必要性

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