[在女性膀出口阻塞的诊断中观察者之间达成一致]
Ana Silvia Vidal-Brandt1, Patricia Castro-Núñez1, Immer Noyola-Ávila1
1Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades, Servicio de Urología. Ciudad de México, México.
Revista medica del Instituto Mexicano del Seguro Social
|November 7, 2023
概括
在女性中诊断膀出口阻塞 (BOO) 是具有挑战性的. 三个定义 (Chassagne,Defreitas,Farrar) 在观察者之间显示出很好的共识,与莱马克和所罗门-格林威尔不同.
科学领域:
- 功能性泌尿器科 功能性泌尿器科
- 女性泌尿器科 女泌尿器科
- 尿动力学 尿动力学
背景情况:
- 在女性中诊断膀输出阻塞 (BOO) 是功能性泌尿病学中的一个重大挑战.
- 关于女性阻塞性症状的患病率的数据有限,一些研究报告在特定患者群体中高达24%.
研究的目的:
- 为了比较六个不同的定义的可靠性,以诊断女性的膀出口阻塞 (BOO).
- 在教育背景下评估这些定义的观察者间协议.
主要方法:
- 对28项尿动力学研究 (UDS) 的回顾性分析,这些研究涉及患有或没有诊断为BOO的女性.
- 对六个BOO定义的评估:法拉尔,查萨尼,莱马克,德弗雷塔斯,布拉维斯和格鲁茨以及所罗门-格林威尔.
- 五名观察员对UDS进行独立审查,评估易度,难度和时间,以及使用kappa统计和错误分类 (解释与错误计算) 的观察者之间的协议.
主要成果:
- 通过使用法拉尔,查萨尼,德弗雷塔斯,布拉维斯和格鲁茨的定义来对BOO进行分类,获得了实质性的观察者间协议 (kappa 0.64-0.78).
- 莱马克和所罗门-格林威尔的定义表现出最低的协议,并被确定为最难应用的.
- 有大量的错误发生,错误计算 (54.1%) 比解释错误 (45.8%) 更频繁.
结论:
- 查萨尼,德弗里塔斯和法拉尔的定义显示了大量的观察者之间的共识,这使得它们成为诊断女性BOO的可靠工具.
- 所罗门-格林韦尔和莱马克的定义存在挑战,导致协议较低,错误发生率更高.
- 标准化UDS解释标准的应用对于在女性患者中准确的BOO诊断至关重要.
相关概念视频
Imaging Studies VI: Voiding Cystourethrography and Cystography
10
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...
10
Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
14
A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
14
Imaging Studies II: Ultrasonography
11
IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
11
Anatomy of the Genitourinary System II: Bladder and Urethra
125
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...
125
Imaging Studies V: Intravenous Urography and Retrograde Pyelography
37
IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
37
Nursing Assessment of the Genitourinary System II: Inspection and Palpation
126
The nursing assessment of the genitourinary (GU) system involves a systematic inspection and palpation to identify abnormalities in the kidneys, bladder, and surrounding structures.InspectionMouth: Inspect for signs of kidney dysfunction, such as stomatitis (inflammation of the mouth) and ammonia breath, which may occur in advanced kidney disease due to the buildup of urea, breaking down into ammonia.Skin: Check for pallor, which could indicate anemia caused by kidney disease. Look for...
126


