Urodinamska dijagnoza subvezikalne opstrukcije – značaj indeksa opstrukcije vrata mokraćne bešike i indeksa kontraktilnosti mokraćne bešike

  • Dimitrije Jeremić University of Novi Sad, Faculty of Medicine, Department of Veterinary Medicine, Novi Sad, Serbia; University Clinical Center of Vojvodina, Urology Clinic, Novi Sad, Serbia
  • Saša Vojinov University of Novi Sad, Faculty of Medicine, Department of Veterinary Medicine, Novi Sad, Serbia; University Clinical Center of Vojvodina, Urology Clinic, Novi Sad, Serbia
  • Stevan Stojanović University of Novi Sad, Faculty of Medicine, Department of Veterinary Medicine, Novi Sad, Serbia; University Clinical Center of Vojvodina, Urology Clinic, Novi Sad, Serbia
  • Ivan Levakov University of Novi Sad, Faculty of Medicine, Department of Veterinary Medicine, Novi Sad, Serbia; University Clinical Center of Vojvodina, Urology Clinic, Novi Sad, Serbia
  • Mladen Popov University of Novi Sad, Faculty of Medicine, Department of Veterinary Medicine, Novi Sad, Serbia; University Clinical Center of Vojvodina, Urology Clinic, Novi Sad, Serbia
  • Miloš Maletin University of Novi Sad, Faculty of Medicine, Department of Veterinary Medicine, Novi Sad, Serbia; University Clinical Center of Vojvodina, Urology Clinic, Novi Sad, Serbia
  • Ines Kalači University Clinical Center of Vojvodina, Urology Clinic, Novi Sad, Serbia
  • Zoran Ružić University of Novi Sad, Faculty of Agriculture, Novi Sad, Serbia
  • Tanja Lakić University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; University Clinical Center of Vojvodina, Center for Pathology and Histology, Novi Sad, Serbia
  • Filip Dožić University Clinical Center of Vojvodina, Urology Clinic, Novi Sad, Serbia
  • Dragan Grbić University Clinical Center of Vojvodina, Urology Clinic, Novi Sad, Serbia
DOI: https://doi.org/10.2298/VSP250304071J
Ključne reči: muškarci;, ureter, opstrukcija;, mokraćna bešika;, mokrenje, poremećaji

Sažetak


Uvod/Cilj. Indeks opstrukcije vrata mokraćne bešike [bladder outlet obstruction (BOO) index – BOOI] koristi se prilikom urodinamskog ispitivanja sa ciljem postavljanja dijagnoze BOO. Indeks kontraktilnosti mokraćne bešike (bladder contractility index – BCI) je urodinamski parametar koji se nekonzistentno koristi u praksi. Cilj rada bio je da se ispita korelacija između BOOI i BCI. Metode. Retrospektivna studija sprovedena je u periodu od 2021–2023 godine i obuhvatila je 176 bolesnika muškog pola. Korišćenjem t-testa, analize varijanse i analize korelacije, analizirani su BOOI i BCI. Rezultati. Visoke vrednosti BOOI (40–80) i slabija kontraktilnost bešike (BCI < 100), kao mogući uzročnici simptoma od strane donjeg urinarnog trakta (lower urinary tract symptoms – LUTS) koegzistiraju u 11,37% slučajeva. Visoka vrednost BCI (> 150) povezana je sa značajnim brojem bolesnika (7,39%) sa visokim vrednostima BOOI (> 40), delujući kao kompenzatorni mehanizam koji prikriva prave uzroke LUTS. U grupama bolesnika sa BCI < 100 i > 150 pokazana je obrnuta korelacija sa BOOI, kao što je i očekivano. Vrednosti BOOI 20–39 i BCI 101–149 mogu se smatrati „sivom zonom“. Korelacija PdetQmax i Qmax nije pokazala statističku značajnost (r = -0,2006), što čini BOO faktorom koji može uticati na ovaj odnos. Pored ovoga, intrauretralni kateter postavljen tokom urodinamskog ispitivanja može u znatnoj meri da utiče na ovaj odnos. Kao što je očekivano, uočava se negativna korelacija između Qmax i BOOI (r = -0,44841, p < 0,001), dok BCI i Qmax imaju pozitivnu linearnu korelaciju (R2 = 0,2255, p < 0,001). Korelacija između dva ispitivana indeksa, BOOI i BCI, pokazuje pozitivnu linearnu povezanost, što ukazuje na postojanje fiziološkog mehanizma za kompenzaciju BOO (R² = 0,3292, p < 0,001). Zaključak. U kombinaciji sa BCI, BOOI je dovoljan za postavljanje definitivne dijagnoze u posmatranim grupama bolesnika. Preporuka je da se BOOI, BCI i Qmax uvek koriste u kombinaciji. Qmax, kao mera koja se najviše analizira prilikom urofloumetrije, može biti nedovoljna za dijagnozu u jasnim kliničkim slučajevima.

Biografija autora

Mladen Popov, University of Novi Sad, Faculty of Medicine, Department of Veterinary Medicine, Novi Sad, Serbia; University Clinical Center of Vojvodina, Urology Clinic, Novi Sad, Serbia

-0002-1825-0097").

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2025/11/27
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Vol. 82 Br. 11 (2025): Vojnosanitetski pregled
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Originalni članak