Klarskov Niels, Lose Gunnar
Department of Obstetrics and Gynaecology, Glostrup University Hospital, Glostrup, Denmark.
BJU Int. 2007 Aug;100(2):351-6. doi: 10.1111/j.1464-410X.2007.06922.x. Epub 2007 May 14.
To compare urethral pressure reflectometry (UPR), a new and simple technique for simultaneous measurements of cross-sectional area (CA) and pressure in the female urethra, with urethral pressure profilometry (UPP).
PATIENTS, SUBJECTS AND METHODS: The study included 143 women (105 patients and 38 healthy volunteers); the UPR was measured using a very thin polyurethane bag in the urethra; a pump applied pre-selected pressures stepwise to the bag and for each step the CA was measured by acoustic reflectometry. Measurements were made during both inflation and deflation. The women were examined supine both while relaxed and during 'squeeze', and while upright and relaxed. The following variables were measured; the opening and closing pressure, the opening and closing elastance and the hysteresis. For UPP we used the perfusion technique with the patient supine and relaxed. All the women were assessed twice with both UPR and UPP at the same setting (short-term reproducibility) and 17 patients were assessed with both methods on two different days (long-term reproducibility).
The mean pressures were 51.7 and 52.9 cmH(2)O for the UPR and UPP, respectively (not significant) at a CA of 5.1 mm(2); the limit of agreement between the methods was -19.4 to +17.0 cmH(2)O (mean and 2 SD). The Pearson coefficient was - 0.16 (not significant). The variability (2 sd) of two consecutive measurements was significantly less with UPR (9.5 cmH(2)O) than UPP (13.8 cmH(2)O; P < 0.001). For the opening and closing pressures the coefficient of variation (CV) was 5.9-11.6%; for the elastances the CV was 14.3-31.2% and for the hysteresis the CV was 12.9-49.1%. In test-retest measurements, the variability of the UPR values (2 sd, 8.7 cmH(2)O) was significantly less than for UPP (15.4 cmH(2)O; P < 0.05). The discomfort of UPR was statistically less than for UPP or than a standard gynaecological examination.
Compared at the same CA, UPR measured the same pressure as UPP but the UPR was more reproducible. With the patient relaxed the opening and closing pressure, opening and closing elastance and the hysteresis can be measured while supine and upright; while squeezing, the opening pressure and elastance can be measured.
比较尿道压力反射测定法（UPR）和尿道压力分布测定法（UPP），前者是一种用于同时测量女性尿道横截面积（CA）和压力的新的简单技术。
患者、受试者与方法：该研究纳入了143名女性（105例患者和38名健康志愿者）；使用非常薄的聚氨酯袋在尿道中测量UPR；通过泵逐步向袋施加预先选定的压力，并在每个步骤通过声学反射测定法测量CA。在充气和放气过程中均进行测量。女性在仰卧位放松状态、“挤压”状态下，以及站立位放松状态下接受检查。测量了以下变量：开放压和关闭压、开放弹性和关闭弹性以及滞后现象。对于UPP，我们采用灌注技术，患者仰卧且放松。所有女性均在相同设置下用UPR和UPP进行两次评估（短期重复性），17例患者在两个不同日期用两种方法进行评估（长期重复性）。
在CA为5.1平方毫米时，UPR和UPP的平均压力分别为51.7和52.9厘米水柱（无显著差异）；两种方法之间的一致性界限为-19.4至+17.0厘米水柱（均值和2个标准差）。皮尔逊系数为-0.16（无显著差异）。连续两次测量的变异性（2个标准差），UPR（9.5厘米水柱）显著低于UPP（13.8厘米水柱；P<0.001）。对于开放压和关闭压，变异系数（CV）为5.9%-11.6%；对于弹性，CV为14.3%-31.2%，对于滞后现象，CV为12.9%-49.1%。在重测测量中，UPR值的变异性（2个标准差，8.7厘米水柱）显著低于UPP（15.4厘米水柱；P<0.05）。UPR带来的不适感在统计学上低于UPP或标准妇科检查。
在相同CA下进行比较时，UPR测量的压力与UPP相同，但UPR的重复性更好。在患者放松状态下，仰卧位和站立位时均可测量开放压和关闭压、开放弹性和关闭弹性以及滞后现象；在“挤压”状态下，可测量开放压和弹性。
