探討骨盆器官的惡性腫瘤對膀胱功能的影響
林憲雄1、2、盧致誠1、林嘉禾1、范文宙1、鄭哲舟1
柳營奇美醫院 外科部 泌尿科1
敏惠醫護管理專科學校2
Explore the characteristics of bladder function of the patients with pelvic organ malignancy
Chian-Shiung Lin1、2, Chih-Cheng Lu1, Chia-Ho Lin 1, Eric W. Fan1, Tse-Chou Cheng1
Divisions of Urology, Department of Surgery, Chi Mei Medical Center, Liouying, Tainan City, Taiwan1
Min-Hwei Junior College of Health Care Management, Tainan City, Taiwan2
Purpose: The primary function of urinary bladder is for urine storage and voiding. Pelvic organ malignancy may deteriorate the originally normal bladder function via either neurogenic or myogenic way. The aim of this study is to compare urodynamic bladder dysfunction among the patients with different pelvic organ malignancies.
Materials and Methods: From January 2010 to June 2015, there were 640 patients eligible for urodynamic analysis. Patients were stratified into 3 groups based on cancer origins (prostate, bladder, and colorectum). The data including gender, age, clinical tumor staging, lower urinary tract symptoms or acute urinary retention, and the parameter values of urodynamic studies were compared among groups. SPSS 17.0.1 for Windows and Microsoft Office Excel 2007 were used for all statistical analysis.
Results: Pelvic organ malignancies included prostatic (40.9%), bladder (33.5%), and colorectal (25.6%) origin. Age ranged from 39 to 95 years (mean 72.93 ± 9.08 years). In uroflowmetry (525 cases), the mean ± standard deviation of maximal urine flow rate was significant lower in prostatic group (11.49 ± 5.53 ml/sec). In cystometrogram (115 cases), the first desire was more sensitive in bladder group (85.52 ± 49.78ml); the cystometric capacity was obvious decreased in prostatic group (161.50±94.29 ml); the maximum voiding pressure and compliance were significant lower in colorectal group (64.58±50.09 cmH2O).
Conclusions: Patients having pelvic organ malignancies may suffer from urination dysfunction. Urinary flow rate obvious decreased in prostate group, more hypersensitive bladder was found in bladder group and bladder dysfunction was poor in colorectal group. The physicians are encouraged to be aware of these urinary complications in patient with pelvic organ oncology.