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Связь между уродинамическими показателями и функцией почек у больных доброкачественной гиперплазией предстательной железы

Связь между уродинамическими показателями и функцией почек у больных доброкачественной гиперплазией предстательной железы

Abstract

The aim of study: to evaluate the relations nature between urodynamic indexes and indexes showing kidneys function in patients with benign prostate hyperplasia (BPH).Patients and methods: complex urological investigation of 291 patients with BPH (middle age 61,3 ± 0,7 years) including urodynamic investigation was done, and for 63 patients the evaluation of glomerular filtration rate was carried out as well.Results: A power of detrusor’s contractility makes an influence to the serum kreatinine level after surgical treatment of BPH (r = –0,54; p = 0,048). The relation between the power of detrusor’s contractility (r = –0,2; p = 0,047) and urea level was showed up, so in case of decreased bladder contractility the level of urea becomes increased. Presence and grade of infravesical obstruction did not influence on kreatinine and urea concentration in a blood (r = –0,16; p = 0,22; r = –0,02; p = 0,89). If detrusor’s contractility become decreased the glomerular filtration rate is decreased too (r = 0,41; p = 0,035) and enlargement of calyxes-pelvic system is present (CPS) (r = 0,41; p = 0,035). The detrusor’s pressure (r = 0,52; p = 0,01) and the bladder capacity (r = 0,44; p = 0,035) in the process of maximal spontaneous contractility make in influence into the CPS as well. At the same time no relations (r = 0,06; p = 0,74) between detrusor’s hyperactivity and enlargement of CPS were found.Сonclusion. Decreasing of detrusor’s contractility and the presence of uncontrollable constructions in case of large volumes of bladder inflating make a bigger influence to the functional condition of upper urinary tract at the patients with benign prostate hyperplasia then a presence and grade of infravesical obstruction.

Цель исследования: оценить характер связи между уродинамическими показателями и показателями, отражающими функцию почек у больных доброкачественной гиперплазией предстательной железы (ДГПЖ). Пациенты и методы: проведено комплексное урологическое обследование 291 больного ДГПЖ (средний возраст 61,3 ± 0,7 лет), включавшее в себя уродинамическое исследование и оценку уровня клубочковой фильтрации (у 63 больных). Результаты: сила сокращения детрузора влияла на уровень креатинина крови после оперативного лечения ДГПЖ (r = –0,54; p = 0,048). Выявлена связь между силой сокращения детрузора (r = –0,2; p = 0,047) и уровнем мочевины, т. е. при сниженной сократимости мочевого пузыря повышался уровень мочевины. Наличие и степень инфравезикальной обструкции (ИВО) не влияла на концентрацию креатинина и мочевины в крови (r = –0,16; p = 0,22; r = -0,02; p = 0,89). При снижении сократимости детрузора снижался уровень клубочковой фильтрации (r = 0,41; p = 0,035) и наблюдалось расширение чашечно-лоханочной системы (ЧЛС) (r = 0,41; p = 0,035). На расширение ЧЛС также влияло детрузорное давление при максимальном непроизвольном сокращении (r = 0,52; p = 0,01) и объем мочевого пузыря при максимальном непроизвольном сокращении (r = 0,44; p = 0,035). В то же время не обнаружено связи ( r = 0,06; p = 0,74) между наличием гиперактивности детрузора и расширением ЧЛС. Заключение: снижение сократительной способности детрузора и наличие непроизвольных его сокращений при больших объемах наполнения мочевого пузыря оказывает большее влияние на функциональное состояние верхних мочевых путей у больных ДГПЖ, чем наличие и степень ИВО.

Keywords

ИНФРАВЕЗИКАЛЬНАЯ ОБСТРУКЦИЯ, СОКРАТИМОСТЬ ДЕТРУЗОРА, ФУНКЦИЯ ПОЧЕК, УРОДИНАМИЧЕСКИЕ ИССЛЕДОВАНИЯ, DETRUSOR’S CONTRACTILITY

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
gold