Yang Jenn-Ming, Huang Wen-Chen
Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei Medical University Taipei, Taiwan, Republic of China.
J Ultrasound Med. 2003 Aug;22(8):777-82. doi: 10.7863/jum.2003.22.8.777.
To explore factors affecting bladder wall thickness on ultrasonographic cystourethrography in female patients with lower urinary tract symptoms.
The records of 492 female patients with lower urinary tract symptoms who had undergone a urodynamic study and ultrasonography of the lower urinary tract and who had normal urinalysis findings, negative urine culture results, or both were identified from our urogynecologic database. These included 248 patients with urodynamic stress incontinence, 38 with detrusor overactivity, 39 with mixed incontinence, 35 with a hypersensitive bladder, 42 with voiding difficulty, and 90 with normal urodynamic findings.
Age, resting bladder neck angle, urethral mobility, and maximum urethral closure pressure were significantly associated with bladder wall thickness at the trigone and dome. Bladder wall thickness at the trigone was correlated with that at the dome (P < .0001). Bladder wall thickness at the trigone was positively correlated with pressure transmission ratios in the first and second quarters of the urethra (P < .0001; P = .002, respectively), whereas that at the dome was positively correlated with intravesical pressure at maximum flow and with detrusor opening pressure (P = .027; P = .046, respectively). Age and intravesical pressure at maximum flow were independently associated with bladder wall thickness at the trigone and dome (P = .007; P = .028), respectively. A thickened bladder wall was a common finding in female lower urinary tract symptoms, except in the patients with a hypersensitive bladder.
Demographic, anatomic, and urodynamic factors may affect the bladder wall thickness at the trigone, dome, or both.
探讨影响下尿路症状女性患者超声膀胱尿道造影时膀胱壁厚度的因素。
从我们的泌尿妇科数据库中识别出492名下尿路症状女性患者的记录，这些患者均接受了尿动力学研究和下尿路超声检查，且尿常规检查结果正常、尿培养结果为阴性或两者均符合。其中包括248例尿动力学压力性尿失禁患者、38例逼尿肌过度活动患者、39例混合性尿失禁患者、35例膀胱过敏患者、42例排尿困难患者以及90例尿动力学检查结果正常的患者。
年龄、静息膀胱颈角度、尿道活动度和最大尿道闭合压与膀胱三角区和膀胱顶部的膀胱壁厚度显著相关。膀胱三角区的膀胱壁厚度与膀胱顶部的膀胱壁厚度相关（P <.0001）。膀胱三角区的膀胱壁厚度与尿道第一和第二季度的压力传递率呈正相关（分别为P <.0001；P =.002），而膀胱顶部的膀胱壁厚度与最大尿流率时的膀胱内压和逼尿肌开放压呈正相关（分别为P =.027；P =.046）。年龄和最大尿流率时的膀胱内压分别独立与膀胱三角区和膀胱顶部的膀胱壁厚度相关（P =.007；P =.028）。膀胱壁增厚是女性下尿路症状中的常见表现，但膀胱过敏患者除外。
人口统计学、解剖学和尿动力学因素可能影响膀胱三角区、膀胱顶部或两者的膀胱壁厚度。
