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目的总结Ⅲ型慢性前列腺炎患者可能存在的下尿路症状,并结合尿流动力学分析各类症状出现的深层次原因。方法对58例Ⅲ型慢性前列腺炎患者的尿流率、膀胱压力容积、压力-流率、前列腺压和肌电图进行综合性回顾分析。并就ⅢA型慢性前列腺炎和ⅢB型慢性前列腺炎的尿动力学变化作了比较。结果41.38%的患者有膀胱活动过度,29.31%的患者有膀胱出口梗阻,另有24.14%的患者存在逼尿肌-外括约肌协同失调。ⅢA型慢性前列腺炎和ⅢB型慢性前列腺炎组中的尿动力学差异无显著性意义。结论慢性前列腺炎患者出现不同程度的尿频、尿急、尿等待和排尿费力等下尿路症状,可能与前列腺局部充血,逼尿肌反射亢进,膀胱出口梗阻和逼尿肌-外括约肌协同失调有关。认识并解除这些相关因素可能有助于提高对慢性前列腺炎的综合疗效。
Objective To summarize the possible lower urinary tract symptoms in patients with type Ⅲ chronic prostatitis and to analyze the underlying causes of various symptoms in combination with urodynamics. Methods A total of 58 patients with type Ⅲ chronic prostatitis were retrospectively analyzed for urinary flow rate, bladder pressure volume, pressure-flow rate, prostate pressure and electromyography. The urodynamic changes of type ⅢA chronic prostatitis and type ⅢB chronic prostatitis were compared. Results 41.38% of patients had overactive bladder, 29.31% of patients had bladder outlet obstruction, and 24.14% of patients had detrusor-external sphincter dysfunction. There was no significant difference in urodynamics between group ⅢA chronic prostatitis and group ⅢB chronic prostatitis. Conclusion Patients with chronic prostatitis may experience lower urinary tract symptoms such as pollakiuria, urinary urgency, urinary waiting and laborious urination, which may be related to prostatic hyperplasia, detrusor hyperreflexia, bladder outlet obstruction and detrusor-external sphincter dysfunction . Understanding and relieving these related factors may help to improve the overall efficacy of chronic prostatitis.