Chen Gin Den, Chen YiChing, Lee Hong Shen, Lin Long Yau
Department of Obstetrics and Gynecology, Chung Shan Medical University, Taichung, Taiwan
J Soc Gynecol Investig. 2003 Jul;10(5):309-13. doi: 10.1016/s1071-5576(03)00088-1.
To evaluate whether anterior vaginal wall prolapse will cause a decrease in urethral pressure.
Two hundred ninety-four patients with uterovaginal prolapse served as study cases. In addition, 127 patients without uterovaginal prolapse were included as controls. The urethral pressure profile measurement was performed using a microtransducer and the fluid-bridge method with the patient in the lithotomy position. The parameters of the urethral pressure profile and its associated variables were compared between the control and study groups.
The proximal portion of urethral pressure and the resting and stress urethral closure pressures in women with anterior vaginal wall prolapse were significantly lower than those of the control group. An indentation segment (or a plateau pressure zone) in the proximal portion of the urethral pressure profile curve was noted in patients with anterior vaginal wall prolapse, especially for stage I (64.2%) and stage II (73.0%). Anterior vaginal wall prolapse and genuine stress incontinence had a statistically significant odds ratio for predicting the presence of an indentation segment (or a plateau pressure zone) in the proximal portion of the urethral pressure profile curve (1.58 and 3.19, respectively).
An indentation segment (or a plateau pressure zone) of the proximal portion of the urethral pressure profile curve was observed in most of our patients with anterior vaginal wall prolapse. Defects in the anterior vaginal wall supports may attenuate the proximal urethral support, and these defects will contribute to a reduction in the proximal urethral pressure.
评估阴道前壁脱垂是否会导致尿道压力降低。
294例子宫阴道脱垂患者作为研究病例。此外，纳入127例无子宫阴道脱垂的患者作为对照。患者取膀胱截石位，使用微型传感器和液桥法进行尿道压力分布测量。比较对照组和研究组的尿道压力分布参数及其相关变量。
阴道前壁脱垂女性的尿道近端压力、静息和应力性尿道闭合压力显著低于对照组。阴道前壁脱垂患者的尿道压力分布曲线近端出现凹陷段（或平台压力区），尤其是I期（64.2%）和II期（73.0%）患者。阴道前壁脱垂和真性压力性尿失禁在预测尿道压力分布曲线近端凹陷段（或平台压力区）的存在方面具有统计学意义的优势比（分别为1.58和3.19）。
在我们大多数阴道前壁脱垂患者中观察到尿道压力分布曲线近端的凹陷段（或平台压力区）。阴道前壁支持结构的缺陷可能会削弱尿道近端的支持，这些缺陷将导致尿道近端压力降低。
