Kenton Kimberly, Fitzgerald Mary P, Brubaker Linda
Loyola University Medical Center, Maywood, Ill, USA.
Am J Obstet Gynecol. 2005 Jan;192(1):55-9. doi: 10.1016/j.ajog.2004.07.016.
The purpose of this study was to determine the relationship between urethral pressure and the neuromuscular activity of the urethral sphincter with the use of quantitative electromyography during bladder filling.
Women who underwent multichannel urodynamic testing with concentric needle electromyography of the striated urethral sphincter between December 2000 and February 2002 were studied. Raw electromyography signals were processed by a electromyography instrument that was equipped with automated motor unit analysis software programs. Quantitative electromyography software was used to analyze the electrical activity of the urethral sphincter during filling cystometry.
One hundred women (mean age, 60 years [range, 22-82 years]; median parity, 3 children [range, 0-8 children]) were studied. Most women (79%) were postmenopausal, and 68% of those women were receiving hormone replacement therapy. Quantitative electromyography values increased significantly at 300 mL and maximum cystometric capacity; however, there was no significant increase in urethral pressure. The median change in urethral pressure at 300 mL and maximum cystometric capacity were 4 cm water (interquartile range, 0-8 cm) and 0 cm water (interquartile range, -4-8 cm), respectively (P = .229). The median change in quantitative electromyography at 300 mL and maximum cystometric capacity were 9 microV (range, 5-14 microV) and 10 microV (range, 7-19 microV), respectively (P < .0005). There was no correlation between change in urethral pressure and motor unit activation on quantitative electromyography at 300 mL or maximum cystometric capacity. Fifty-six women had no change or a decreased urethral pressure at maximum cystometric capacity, yet all but 1 of these women had increased motor unit activation on quantitative electromyography.
Urethral pressure does not increase during filling cystometry, despite increased activity of the striated urethral sphincter, which suggests that urethral pressure change does not reflect the integrity of the striated urethral sphincter.
本研究旨在通过膀胱充盈期定量肌电图来确定尿道压力与尿道括约肌神经肌肉活动之间的关系。
对2000年12月至2002年2月期间接受多通道尿动力学检查并同时进行横纹肌尿道括约肌同心针肌电图检查的女性进行研究。原始肌电图信号由配备自动运动单位分析软件程序的肌电图仪进行处理。使用定量肌电图软件分析膀胱测压充盈期尿道括约肌的电活动。
共研究了100名女性（平均年龄60岁[范围22 - 82岁]；中位产次3个孩子[范围0 - 8个孩子]）。大多数女性（79%）已绝经，其中68%的女性正在接受激素替代疗法。在膀胱容量为300 mL和最大膀胱测压容量时，定量肌电图值显著增加；然而，尿道压力并无显著升高。膀胱容量为300 mL和最大膀胱测压容量时尿道压力的中位变化分别为4 cm水柱（四分位间距0 - 8 cm）和0 cm水柱（四分位间距 - 4 - 8 cm）（P = 0.229）。膀胱容量为300 mL和最大膀胱测压容量时定量肌电图的中位变化分别为9 μV（范围5 - 14 μV）和10 μV（范围7 - 19 μV）（P < 0.0005）。在膀胱容量为300 mL或最大膀胱测压容量时，尿道压力变化与定量肌电图上的运动单位激活之间无相关性。56名女性在最大膀胱测压容量时尿道压力无变化或降低，但这些女性中除1人外，其余所有人在定量肌电图上的运动单位激活均增加。
在膀胱测压充盈期，尽管横纹肌尿道括约肌活动增加，但尿道压力并未升高，这表明尿道压力变化不能反映横纹肌尿道括约肌的完整性。
