尿流動態検査および排尿時膀胱尿道造影で正確に診断された女性の排尿機能障害3例

We performed a urodynamic study (UDS) and voiding cystourethrography (VCUG) or videourodynamics for three female patients with urinary dysfunction to differentiate between bladder outlet obstruction (BOO) and detrusor underactivity (DU). Case 1: A 72-year-old woman with a history of urinary retention and chief complaint of dysuria. UDS showed detrusor contraction (detrusor pressure at maximum flow: PdetQmax 86.6 cmH₂O) and low urinary flow (maximum flow rate: Qmax 2.2 ml/s). VCUG showed poor bladder neck opening and bilateral vesicoureteral reflux and we diagnosed BOO due to bladder neck dysfunction. Case 2: A 74-year-old woman with dysuria. UDS showed detrusor contraction (PdetQmax 27.7 cmH₂O) and low urinary flow (Qmax 5.3 ml/s). VCUG showed the open bladder neck and narrowing of the middle urethra during voiding. We diagnosed BOO due to abnormal urethral function during voiding. Case 3: An 85-year-old woman with a chief complaint of nocturia. UDS showed weak detrusor contraction (PdetQmax 18.3 cmH₂O) and low urinary flow (Qmax 3.8 ml/s). VCUG revealed urethral dilatation. We diagnosed DU. The combination of UDS and VCUG for female urinary dysfunction may be a useful tool for the differential diagnosis of DU and BOO.