Summitt R L, Stovall T G
Department of Obstetrics and Gynecology, University of Tennessee, Memphis.
Obstet Gynecol. 1992 Oct;80(4):695-9.
To compare the value of urethral pressure profilometry with that of cystourethroscopy and the voiding cystourethrogram in the evaluation and management of urethral diverticula.
Twelve women with signs or symptoms of a urethral diverticulum were referred. The initial evaluation included cystourethroscopy and a voiding cystourethrogram. All then underwent urethral pressure profilometry.
Nine of 12 patients had urethral diverticula, two had Skene duct cysts, and one had genuine stress incontinence. Both cystourethroscopy and voiding cystourethrography demonstrated diverticula in all patients who had them. Excision was the preliminary surgical plan in these women. Urethral pressure profilometry demonstrated a pressure depression or biphasic curve in all nine cases with diverticula. Stress incontinence was noted in one of these nine women. A biphasic curve was also noted in one woman with a Skene duct cyst and in the one who had genuine stress incontinence only. According to preset criteria for profilometry, excision was the planned operative procedure for all.
Cystourethroscopy and voiding cystourethrography were satisfactory techniques for diagnosing urethral diverticula and planning appropriate surgical treatment. The urethral pressure profile confirmed the presence of a diverticulum, but noted pressure depressions in cases other than diverticula. Profilometry did not change the surgical plan for treating diverticula, but allowed the planning of additional incontinence surgery in one patient.
比较尿道压力测定法与膀胱尿道镜检查及排尿期膀胱尿道造影在评估和处理尿道憩室中的价值。
收治12例有尿道憩室体征或症状的女性患者。初始评估包括膀胱尿道镜检查和排尿期膀胱尿道造影。随后所有患者均接受尿道压力测定。
12例患者中，9例有尿道憩室，2例有斯基恩氏腺囊肿，1例有真性压力性尿失禁。膀胱尿道镜检查和排尿期膀胱尿道造影在所有存在相应病变的患者中均显示出憩室。这些女性患者的初步手术方案为切除。尿道压力测定在所有9例憩室患者中均显示出压力降低或双相曲线。这9例女性患者中有1例存在压力性尿失禁。1例斯基恩氏腺囊肿患者及仅患有真性压力性尿失禁的1例患者也显示出双相曲线。根据预设的压力测定标准，所有患者的计划手术方式均为切除。
膀胱尿道镜检查和排尿期膀胱尿道造影是诊断尿道憩室及规划适当手术治疗的满意技术。尿道压力曲线证实了憩室的存在，但在憩室以外的病例中也发现了压力降低情况。压力测定未改变治疗憩室的手术方案，但使得为1例患者规划了额外的尿失禁手术。
