School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada.
Neurourol Urodyn. 2010 Mar;29(3):437-42. doi: 10.1002/nau.20773.
The purpose of this study was to determine if, compared to continent women, women with stress urinary incontinence (SUI) generate lower intravaginal pressure (IVP) during maximum voluntary pelvic floor muscle contractions (PFM MVCs) or coughing, slower contraction times or less ability to sustain IVP, and if there are reductions in the ability to generate IVP during these tasks associated with increasing age.
Eighty-seven (35 continent, 35 with mild SUI and 17 with severe SUI) women participated. IVP data were acquired while participants performed PFM MVCs, maximum effort coughs and a sustained PFM contraction. The maximum IVP amplitudes measured during the MVCs and coughs, the time for IVP to reach a peak during coughing and the time for the IVP to drop by 50% during the sustained contraction were compared among the groups using separate analyses of covariance, with age included as a covariate.
There were no differences in maximum PFM MVC IVP or in endurance time among the groups. Women with SUI produced higher cough IVP amplitudes than continent women. Age was associated with a reduction in IVP and with longer contraction times during coughing.
The data suggest that PFM weakness may not be an important factor in the pathophysiology of SUI. Women with SUI may intuitively use their PFMs to compensate for urethral sphincter or fascial deficits. The IVP generated during coughing and the speed at which peak IVP is attained are, however, substantially reduced with increasing age, which might affect continence in older women.
本研究旨在确定与 continent 女性相比，压力性尿失禁（SUI）女性在最大自主骨盆底肌肉收缩（PFM MVC）或咳嗽时是否产生较低的阴道内压力（IVP）、收缩时间较慢或维持 IVP 的能力较低，以及在这些任务中 IVP 的产生能力是否会随着年龄的增长而降低。
87 名女性（35 名 continent 女性、35 名轻度 SUI 女性和 17 名重度 SUI 女性）参与了本研究。参与者在进行 PFM MVC、最大努力咳嗽和持续 PFM 收缩时，获取 IVP 数据。使用协方差分析分别比较各组在 MVC 和咳嗽期间测量的最大 IVP 幅度、咳嗽时 IVP 达到峰值的时间以及持续收缩时 IVP 下降 50%的时间，年龄作为协变量。
各组之间的最大 PFM MVC IVP 或耐力时间没有差异。SUI 女性产生的咳嗽 IVP 幅度高于 continent 女性。年龄与 IVP 减少和咳嗽时收缩时间延长有关。
数据表明，PFM 无力可能不是 SUI 病理生理学的重要因素。SUI 女性可能会直观地使用她们的 PFM 来补偿尿道括约肌或筋膜缺陷。然而，随着年龄的增长，咳嗽时产生的 IVP 和达到峰值 IVP 的速度会大幅降低，这可能会影响老年女性的尿控能力。
