Chaliha Charlotte, Digesu G Alessandro, Hutchings Anna, Khullar Vik
Urogynaecology Unit, St Mary's Hospital, Imperial College Faculty of Medicine, London, United Kingdom.
Am J Obstet Gynecol. 2005 Jan;192(1):60-5. doi: 10.1016/j.ajog.2004.07.039.
The purpose of this study was to assess the effect of detrusor overactivity and bladder filling on urethral function with the use of urethral profilometry.
Women with symptoms of urinary incontinence were recruited from our urodynamic clinic. All of the women underwent videocystourethrography and urethral pressure profilometry with the bladder empty and then full. The maximum urethral closure pressure, mean urethral pressure, functional urethral length, and pressure transmission ratios for each quartile were analyzed.
Thirty-five women were recruited: 17 women had urodynamic stress incontinence, and 18 women had detrusor overactivity. In women with urodynamic stress incontinence, there was a significant increase in maximum urethral closure pressure and pressure transmission ratios over all quartiles when the bladder was full compared with empty. In women with detrusor overactivity, there was a significant decrease in functional urethral length and pressure transmission ratios in the second and third quartile of the urethral pressure profiles when the bladder was full compared with empty.
Decreases in functional urethral length and pressure transmission ratios with bladder filling in those women with detrusor overactivity are at variance with the normal physiologic response to bladder filling, which suggests that urethral function is affected by the presence of abnormal detrusor activity and that the valid assessment of urethral function may not be possible if the detrusor overactivity is not treated.
本研究旨在通过尿道压力测定法评估逼尿肌过度活动和膀胱充盈对尿道功能的影响。
从我们的尿动力学诊所招募有尿失禁症状的女性。所有女性在膀胱排空和充盈时均接受了膀胱尿道造影和尿道压力测定。分析了每个四分位数的最大尿道闭合压、平均尿道压、功能性尿道长度和压力传递率。
招募了35名女性：17名女性患有尿动力学压力性尿失禁，18名女性患有逼尿肌过度活动。在患有尿动力学压力性尿失禁的女性中，与膀胱排空时相比，膀胱充盈时所有四分位数的最大尿道闭合压和压力传递率均显著增加。在患有逼尿肌过度活动的女性中，与膀胱排空时相比，膀胱充盈时尿道压力曲线的第二和第三四分位数的功能性尿道长度和压力传递率显著降低。
逼尿肌过度活动的女性在膀胱充盈时功能性尿道长度和压力传递率降低，这与膀胱充盈的正常生理反应不同，这表明尿道功能受异常逼尿肌活动的影响，并且如果不治疗逼尿肌过度活动，可能无法对尿道功能进行有效评估。
