Peschers U M, Jundt K, Dimpfl T
Department of Obstetrics and Gynecology, Klinikum Innenstadt Ludwig-Maximilians-Universitaet, Munich, Germany.
Neurourol Urodyn. 2000;19(6):677-81. doi: 10.1002/1520-6777(2000)19:6<677::aid-nau5>3.0.co;2-j.
The aim of the study was to evaluate the relationship between Valsalva leak-point pressure (VLPP) and cough leak-point pressure (CLPP). Sixty women with stress urinary incontinence were included. One woman was excluded from evaluation because of detrusor instability. At a bladder volume of 200-300 mL (mean, 284; standard deviation, 29) CLPP and VLPP were measured in the sitting position. Intra-abdominal pressure was recorded with a rectal balloon catheter. A standardized pad test and multi-channel urodynamics were performed. VLPP was significantly lower than CLPP (58.9+/-27.6 versus 112.5+/-46.9 cm H(2)O, P<0.0001). Although CLPP was negative in two women only, VLPP was negative in 24 of 59 women (40.1%). If intrinsic sphincter deficiency was defined as a leak-point pressure of 65 cm H(2)O, 16.9% of women fulfilled this criterion using the CLPP compared to 35.6% if the VLPP is used. In conclusion, coughing and Valsalva seem to result in a different reaction of the pelvic floor.
该研究的目的是评估瓦尔萨尔瓦漏点压力（VLPP）与咳嗽漏点压力（CLPP）之间的关系。纳入了60名压力性尿失禁女性。一名因逼尿肌不稳定被排除在评估之外。在膀胱容量为200 - 300 mL（平均284；标准差29）时，于坐位测量CLPP和VLPP。用直肠球囊导管记录腹内压。进行了标准化的尿垫试验和多通道尿动力学检查。VLPP显著低于CLPP（58.9±27.6对112.5±46.9 cm H₂O，P<0.0001）。虽然只有两名女性的CLPP为阴性，但59名女性中有24名（40.1%）的VLPP为阴性。如果将固有括约肌缺陷定义为漏点压力65 cm H₂O，使用CLPP时16.9%的女性符合该标准，而使用VLPP时为35.6%。总之，咳嗽和瓦尔萨尔瓦动作似乎会导致盆底产生不同反应。
