量化男性膀外流阻塞:比较利用大数据样本的四种近似方法
Wouter van Dort1, Peter F W M Rosier1, Bernard J Geurts2
1Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands.
Neurourology and urodynamics
|August 24, 2023
概括
三参数方法 (3PM) 最准确地估计了膀外流阻塞 (BOO) 的最小尿道开口压力 (pmuo). 线性被动尿道阻力关系 (linPURR) 是评估BOO的最生理准确的方法.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 尿动力学 尿动力学
- 下尿道的症状 下尿道的症状
背景情况:
- 压力流量研究 (PFS) 是评估尿道抵抗 (UR) 和膀外流阻塞 (BOO) 的黄金标准.
- 最低尿道开口压力 (pmuo) 是患有良性前列腺增生症的男性中BOO的一个关键参数.
- 由于终端滴滴,对pmuo的直接测量具有挑战性,需要使用替代估计方法.
研究的目的:
- 从PFS数据中比较四种已确定的方法来近似pmuo.
- 评估pmuo和最大尿液流速 (Qmax) 与相应的压力 (pdetQmax) 之间的关系.
- 确定在临床实践中评分UR和评估BOO的最准确方法.
主要方法:
- 分析了1717名具有下尿路症状的男性高质量的PFS.
- 使用三个单参数方法和一个三参数方法 (3PM) 计算pmuo.
- 估计的pmuo值与精确评估的pmuo值进行比较,精度定义为<10 cmH2O差异.
主要成果:
- 3PM模型表现出卓越的准确性,75.9%的近似值在实际pmuo的10cmH2O以内.
- 尿道阻力A (URA) 和线性化被动尿道阻力关系 (linPURR) 显示可比性可靠性.
- 膀外流阻塞指数 (BOOI) 是最不准确的方法,在更高的UR等级中倾向于高估pmuo.
结论:
- 在估计pmuo和量化BOO方面,3PM方法是最准确的,而BOOI是最不准确的.
- 鉴于其一般的不可用性和在低质量的PFS中未知的性能,linPURR被认为是目前生理上最准确的方法.
- 需要进一步的研究来确定估计方法之间观察到的差异的临床相关性.
相关概念视频
Urodynamic Studies: Uroflowmetry
83
Uroflowmetry is a non-invasive urodynamic test designed to measure various aspects of urination, including volume, flow rate, and the time to void. This test is crucial for diagnosing and assessing conditions such as bladder outlet obstruction, bladder dysfunction, incomplete bladder emptying, incontinence, and urinary tract blockages caused by benign prostatic hyperplasia (BPH) and urethral strictures.Pre-Test Instructions:Before a uroflowmetry test, patients are typically advised to drink...
83
Imaging Studies VI: Voiding Cystourethrography and Cystography
32
Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
32
One-Compartment Open Model: Urinary Excretion Data and Determination of k
219
The one-compartment open model leverages urinary excretion data to estimate renal clearance, which gauges the kidney's capacity to expel a drug. This method offers several benefits, including directly measuring drug elimination and assessing the kidney's contribution to overall drug clearance. However, this approach has limitations. It assumes sole renal excretion of the drug, which is not true for all drugs. Accurate urinary excretion and plasma drug concentration measurement can also...
219
Determination of Renal Drug Clearance: Graphical and Midpoint Methods
156
Renal clearance, a crucial parameter in pharmacokinetics, can be determined using two different methods: the graphical method and the midpoint method. These methods provide insights into the rate of drug excretion by the kidneys and aid in assessing renal function.
The graphical method involves plotting the rate of drug excretion in urine against the plasma drug concentration. By analyzing the graph, the clearance can be calculated and obtained. Drugs rapidly excreted by the kidneys exhibit a...
The graphical method involves plotting the rate of drug excretion in urine against the plasma drug concentration. By analyzing the graph, the clearance can be calculated and obtained. Drugs rapidly excreted by the kidneys exhibit a...
156
Pipe Flowrate Measurement
740
In pipe flow measurement, orifice, nozzle, and Venturi meters are commonly used to determine fluid flowrates by constricting the flow area, which increases fluid velocity and reduces pressure. This pressure difference, governed by Bernoulli's principle and adjusted for real-world conditions, is essential for calculating flowrate. Each meter type is suited to specific applications based on accuracy, efficiency, and compatibility with various flow conditions.
The orifice meter is a simple,...
The orifice meter is a simple,...
740
Anatomy of the Genitourinary System II: Bladder and Urethra
126
The lower urinary system consists of the urinary bladder and urethra, which are essential in storing and expelling urine from the body. Together with the internal and external sphincters, these structures work together to regulate urination effectively.Anatomy of the BladderThe urinary bladder is a muscular, stretchable organ behind the pubic bone and in front of the rectum. In females, the bladder is positioned anterior to the vagina and inferior to the uterus, while in males, it is located...
126


