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目的:从尿动力学角度阐明乙状结肠原位新膀胱的尿动力学特点,为该术式提供尿动力学依据。方法:2000年1月～2006年3月间对乙状结肠原位新膀胱术的20例患者进行随访,并获得尿动力学检测等资料。结果:随访期间发现,代膀胱容量逐渐增大,而充盈期最大压力逐渐减低;最大尿流率也逐渐增大,而排尿期最大压力和剩余尿量逐渐减少;膀胱颈压和最大尿道压逐渐增大;上述指标在术后3～6个月开始稳定在正常水平。随访期间均无肾积水,未见输尿管梗阻及反流,血清电解质及肾功能均正常。结论:乙状结肠原位新膀胱术储尿囊具有较好的顺应性,适当容量,一定的低压和良好的抗反流作用;而术后进行膀胱功能训练是必要和有益的,观察发现3～6个月基本恢复稳定的代膀胱功能,且患者具有较好的生活质量。
OBJECTIVE: To clarify urodynamic features of orthotopic bladder in sigmoid colon from the urodynamic point of view, to provide urodynamic basis for the procedure. Methods: From January 2000 to March 2006, 20 patients with sigmoid colon in situ neobladder were followed up and their urodynamic data were obtained. Results: During the follow-up period, the capacity of the substitute bladder gradually increased while the maximum pressure of the filling stage decreased gradually. The maximum urinary flow rate also gradually increased while the maximum pressure and residual urine volume of the urination period gradually decreased. The bladder neck pressure and the maximum urethral pressure gradually increased Increased; the above indicators began to stabilize at normal levels 3 to 6 months after surgery. No hydronephrosis during follow-up, no ureteral obstruction and reflux, serum electrolytes and renal function were normal. CONCLUSIONS: The sigmoid colon in situ neo-bladder surgery has good compliance, proper capacity, low pressure and good anti-reflux function. Bladder function training is necessary and beneficial after operation. It is observed that 3-6 Month basically restore the stability of the bladder function, and patients with better quality of life.