Dolan Lucia M, Smith Anthony R B, Hosker Gordon L
The Warrell Unit, Saint Mary's Hospital, Whitworth Park, Manchester M13 OJH, United Kingdom.
Neurourol Urodyn. 2004;23(1):10-5. doi: 10.1002/nau.10165.
Women with urodynamic stress incontinence (USI) have lower opening and closing detrusor pressures than women without USI. This study was undertaken to determine whether a change occurs in opening and closing detrusor pressures after colposuspension, whether cure is associated with change, and whether age influences cure.
Retrospective cohort study.
Tertiary referral urogynaecology department.
Consecutive women who had undergone colposuspension between 1998-2000 and 1993-1995.
Pre- and post-operative urodynamic records were reviewed. Eighty eight women were included. Objective cure was defined as an absence of USI and subjective cure as an absence of symptoms of stress incontinence.
Mean age was 52.4 (11.0) years. Sixty nine percent (61/88) were objectively cured and 48% (42/88) were subjectively cured. Postoperatively, opening detrusor pressure increased (P = 0.0001) and maximum flow rate decreased (P= 0.0464) in women objectively cured but these parameters did not change in the not cured group (P > 0.05). Women had a 4.5 times higher chance of failed surgery if post-op opening detrusor pressure was < or =20 cmH2O (P = 0.035). Opening detrusor pressure declined with age (P < 0.001) and women who were objectively cured were on average almost 7 years younger (P = 0.0330).
Increase in opening detrusor pressure occurs only in women who are cured following colposuspension. Change in opening detrusor pressure is dependent on age and objective cure is higher in younger women. The effects of ageing on sub-urethral supports might explain why surgery is more likely to fail in older women.
与无尿动力学压力性尿失禁（USI）的女性相比，患有USI的女性逼尿肌开放和闭合压力更低。本研究旨在确定膀胱颈悬吊术后逼尿肌开放和闭合压力是否发生变化，治愈是否与这些变化相关，以及年龄是否影响治愈情况。
回顾性队列研究。
三级转诊泌尿妇科科室。
1998 - 2000年和1993 - 1995年间接受膀胱颈悬吊术的连续女性患者。
回顾术前和术后的尿动力学记录。纳入88名女性。客观治愈定义为无USI，主观治愈定义为无压力性尿失禁症状。
平均年龄为52.4（11.0）岁。69%（61/88）的患者实现客观治愈，48%（42/88）的患者实现主观治愈。术后，客观治愈的女性患者逼尿肌开放压力升高（P = 0.0001），最大尿流率降低（P = 0.0464），而未治愈组这些参数无变化（P > 0.05）。如果术后逼尿肌开放压力≤20 cmH₂O，手术失败的几率会高出4.5倍（P = 0.035）。逼尿肌开放压力随年龄下降（P < 0.001），客观治愈的女性平均年龄比未治愈者小近7岁（P = 0.0330）。
只有膀胱颈悬吊术后治愈的女性逼尿肌开放压力会升高。逼尿肌开放压力的变化取决于年龄，年轻女性的客观治愈率更高。衰老对尿道下支撑结构的影响可能解释了为何老年女性手术失败的可能性更大。
