Lowenstein Lior, Dooley Yashika, Kenton Kimberly, Rickey Leslie, FitzGerald Mary Pat, Mueller Elizabeth, Brubaker Linda
Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, Illinois 60153, USA.
J Urol. 2007 Jul;178(1):193-6. doi: 10.1016/j.juro.2007.03.031. Epub 2007 May 17.
We determined if the bladder volume at which urodynamic stress incontinence is first detected is related to preoperative quality of life, urethral sphincter assessment or surgical outcome in women undergoing continence surgery.
Charts of consecutive women who underwent a sling or Burch procedure were reviewed. Preoperative and postoperative assessment included the Incontinence Impact Questionnaire and Urogenital Distress Inventory. Urodynamic stress incontinence volume is the bladder volume at which urodynamic stress incontinence was first detected. Women were divided into 4 groups according to urodynamic stress incontinence volume, and compared with respect to maximum urethral closure pressure, Valsalva leak point pressure, Incontinence Impact Questionnaire and Urogenital Distress Inventory. Urodynamic stress incontinence persistence was evaluated only in patients who had sling surgery.
A total of 168 women were recruited for the study. Urodynamic stress incontinence volume was 100 ml for 31% of women, 200 ml for 17%, 300 ml for 17% and 400 ml or greater for 35%. Baseline and postoperative Urogenital Distress Inventory, Incontinence Impact Questionnaire, maximal urethral closure pressure and Valsalva leak point pressure did not differ by urodynamic stress incontinence volume. Among the 116 patients who had the sling procedure, urodynamic stress incontinence persistence did not differ by urodynamic stress incontinence volume (p=0.72).
Women who demonstrate urodynamic stress incontinence at lower bladder volumes do not report greater bother from incontinence than women who leak at higher volumes, suggesting leakage severity on urodynamics is not an adequate reflection of incontinence related quality of life.
我们确定了首次检测到尿动力学压力性尿失禁时的膀胱容量是否与接受尿失禁手术的女性术前生活质量、尿道括约肌评估或手术结果相关。
回顾了连续接受吊带手术或Burch手术的女性患者的病历。术前和术后评估包括尿失禁影响问卷和泌尿生殖系统困扰量表。尿动力学压力性尿失禁容量是首次检测到尿动力学压力性尿失禁时的膀胱容量。根据尿动力学压力性尿失禁容量将女性分为4组，并比较最大尿道闭合压、Valsalva漏尿点压力、尿失禁影响问卷和泌尿生殖系统困扰量表。仅对接受吊带手术的患者评估尿动力学压力性尿失禁的持续情况。
共招募了168名女性进行研究。31%的女性尿动力学压力性尿失禁容量为100 ml，17%为200 ml，17%为300 ml，35%为400 ml或更大。基线和术后泌尿生殖系统困扰量表、尿失禁影响问卷、最大尿道闭合压和Valsalva漏尿点压力在尿动力学压力性尿失禁容量方面无差异。在接受吊带手术的116例患者中，尿动力学压力性尿失禁的持续情况在尿动力学压力性尿失禁容量方面无差异（p = 0.72）。
与膀胱容量较高时出现漏尿的女性相比，膀胱容量较低时出现尿动力学压力性尿失禁的女性报告的尿失禁困扰并不更大，这表明尿动力学上的漏尿严重程度并不能充分反映与尿失禁相关的生活质量。
