Schick Erik, Tessier Jocelyne, Bertrand Pierre E, Dupont Charles, Jolivet-Tremblay Martine
Hôpital Maisonneuve-Rosemont, Division of Urology, Université de Montréal, Montreal, Canada.
Neurourol Urodyn. 2003;22(7):643-7. doi: 10.1002/nau.10148.
To study the relation between maximum urethral closure pressure at rest and urethral hypermobility in female patients.
We selected 255 patients aged 20 years and older, with a stable bladder on multichannel urodynamics, without known neurological pathology, and without a history of pelvic or anti-incontinence surgery. A resting urethral pressure profile and the degree of urethral hypermobility were registered. Two-tailed analyses of variance (ANOVA) with Fisher's post-hoc tests were used to detect any statistically significant difference (P < 0.05) in urethral closure pressure between groups with varying degrees of urethral hypermobility.
Mean age was 45.6 +/- 12.7 (range 20-77) years. Mean maximum urethral closure pressure for the entire group was 62.7 +/- 29 (range 10-150) cm of water. A statistically significant inverse relationship was found between age and maximum urethral closure pressure (r = 0.489, P < 0.0001) when both analyzed as continuous variables, and with age categorized in 10-year increments (P < 0.0001). When comparing mean urethral closure pressure in each group examined for urethral hypermobility, a statistically significant difference was noted when grades I, II, and III were compared to grade 0 hypermobility. No significant difference was observed when grades I, II, and III were compared to each other. Even if statistically non-significant, there exists an inverse relationship between the degree of urethral hypermobility and the maximum urethral closure pressure: a higher hypermobility is associated with a lesser urethral closure pressure.
Urethral closure pressure falls significantly when urethral hypermobility is present. This decrease is not related to patient's age or parity. Our observations demonstrate an inverse relation between urethral closure pressure and the degree of cysto-urethrocele. As hypermobility increases, closure pressure decreases, even if this decrease does not reach the level of statistical significance.
研究女性患者静息时最大尿道闭合压与尿道活动过度之间的关系。
我们选取了255名年龄在20岁及以上的患者，这些患者在多通道尿动力学检查中膀胱功能稳定，无已知神经病理学问题，且无盆腔或抗尿失禁手术史。记录静息尿道压力分布图和尿道活动过度程度。采用双尾方差分析（ANOVA）及Fisher事后检验，以检测不同程度尿道活动过度组之间尿道闭合压的任何统计学显著差异（P < 0.05）。
平均年龄为45.6±12.7（范围20 - 77）岁。整个组的平均最大尿道闭合压为62.7±29（范围10 - 150）厘米水柱。当将年龄和最大尿道闭合压作为连续变量分析时，发现两者之间存在统计学显著的负相关关系（r = 0.489，P < 0.0001），并且当按10年增量对年龄进行分类时也存在这种关系（P < 0.0001）。在比较每个检查尿道活动过度的组的平均尿道闭合压时，将I级、II级和III级与0级活动过度进行比较时发现有统计学显著差异。I级、II级和III级之间相互比较时未观察到显著差异。即使在统计学上不显著，尿道活动过度程度与最大尿道闭合压之间也存在负相关关系：活动过度程度越高，尿道闭合压越低。
存在尿道活动过度时，尿道闭合压显著下降。这种下降与患者年龄或产次无关。我们的数据表明尿道闭合压与膀胱尿道膨出程度之间存在负相关关系。随着活动过度增加，闭合压降低，即使这种降低未达到统计学显著水平。
