#22828 скачать в хорошем качестве

#22828

Solomon-Greenwell as the Most Accurate Nomogram for Female Bladder Outlet Obstruction Castro-Nuñez P1, Noyola-Avila I1, Maldonado-Alcaraz E1, Moreno-Palacios J1 1. Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Mexico City. KEYWORDS: Bladder Outlet Obstruction , Female, Voiding Dysfunction Introduction The diagnosis of bladder outlet obstruction (BOO) in women has become a challenge for Urology. There exist accepted nomograms for men such as the Abrams-Griffiths, the linpuRRR nomograms and the International Continence Society, any of these are applicable for women because the etiological factors for BOO are more diverse in females. The dynamics of voiding in females is more complex due to mobility of the bladder neck, proximal urethra and action of pelvic floor movements, whereas benign prostatic hyperplasia is the main cause in men. Normal voiding consists in a sustained and voluntary contraction of the detrusor muscle capable of evacuate the contents completely due of a coordinated and sustained relaxation of the external urethral sphincter and the entire pelvic floor. Voiding symptoms like poor urinary stream hesitancy, straining and sense of incomplete emptying are suggestive of BOO, anyway a complete urodynamic evaluation must confirm it, other useful diagnostic studies are the ultrasonography in which the presence of residual urine volume higher than 150 cc is suggestive of BOO and cystoscopy which could determine the site of obstruction. Not only the absence of an etiology well identified, but also the lack of a universal agreement in urodynamics has resulted in the development of many definitions for BOO exclusively for women, plenty of definitions have taken place, yet it hasn’t been standardized Objectives: The aim of our study is to compare the different definitions for BOO and find which one is most specific and sensitive in order to achieve a more accurate diagnosis