Arunkalaivanan A S, Mahomoud S, Howell M
Department of Urodynamics & Urogynaecology, City Hospital, Dudley Road, Birmingham, B18 7QH, UK.
Int Urogynecol J Pelvic Floor Dysfunct. 2004 Nov-Dec;15(6):422-4; discussion 424. doi: 10.1007/s00192-004-1195-z. Epub 2004 Jul 1.
The objective of this study was to investigate the effect of lying and sitting positions on urodynamic parameters and diagnoses. This prospective study was carried out on 96 women with urinary incontinence who underwent urodynamic assessment. Cystometry was performed both in the lying and sitting positions. For filling cystometry, we infused normal saline at a rate of 50 ml/min. All the results were entered on the urodynamic database and were analysed using Minitab software release 13.30. Mean age was 49 (20-84) years. Sixty-four (67%) women complained of mixed incontinence, 16 (17%) of urgency alone, eight (8%) of stress incontinence and eight (8%) of urgency and urge incontinence. Two (2%) showed stress incontinence by lying cystometry, and 53 (55%) by sitting cystometry. During lying nine (9%) demonstrated detrusor overactivity, while 53 (55%) demonstrated detrusor overactivity in sitting position. No case of mixed incontinence was diagnosed by lying cystometry but 17 (18%) cases were detected by sitting cystometry. This study explains the higher detection rate of stress incontinence, detrusor overactivity and mixed incontinence by cystometry in sitting position. Therefore, we recommend that sitting posture is preferred over lying position for performing cystometry.
本研究的目的是调查卧位和坐位对尿动力学参数及诊断的影响。这项前瞻性研究对96例接受尿动力学评估的尿失禁女性进行。分别在卧位和坐位进行膀胱测压。对于充盈期膀胱测压，我们以50毫升/分钟的速率输注生理盐水。所有结果都录入尿动力学数据库，并使用Minitab 13.30版软件进行分析。平均年龄为49（20 - 84）岁。64例（67%）女性主诉混合性尿失禁，16例（17%）仅为急迫性尿失禁，8例（8%）为压力性尿失禁，8例（8%）为急迫性和紧迫性尿失禁。2例（2%）卧位膀胱测压显示压力性尿失禁，53例（55%）坐位膀胱测压显示压力性尿失禁。卧位时有9例（9%）出现逼尿肌过度活动，而坐位时有53例（55%）出现逼尿肌过度活动。卧位膀胱测压未诊断出混合性尿失禁病例，但坐位膀胱测压检测到17例（18%）。本研究解释了坐位膀胱测压时压力性尿失禁、逼尿肌过度活动和混合性尿失禁的检出率较高。因此，我们建议进行膀胱测压时首选坐位而非卧位。
