Pham Khanh N, Topp Nicole, Guralnick Michael L, Koduri Sumana, Newcomer Julianne R, O'Connor Robert Corey
Department of Urology, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA.
Int Urogynecol J. 2010 Oct;21(10):1243-6. doi: 10.1007/s00192-010-1177-2. Epub 2010 May 18.
A subset of neurologically normal females void by efficient Valsalva, not detrusor contraction. We determined the incidence of urinary retention following midurethral sling (MUS) placement in women that void by detrusor contraction versus Valsalva.
Review of patients undergoing MUS insertion between 2002 and 2009 for urodynamic stress incontinence was performed. Women with concomitant pelvic surgery, previous incontinence surgery, or preoperative incomplete bladder emptying were excluded. Patients were divided into two cohorts based on preoperative urodynamic findings--those that voided with a detrusor contraction >10 cm of water and those that voided by Valsalva.
One hundred seven patients were available for analysis. The postoperative urinary retention rate was 22% and 5% in the Valsalva and non-Valsalva groups, respectively (p < 0.05). Mean retention duration was 3 weeks for each cohort (range 1-6).
Women voiding by Valsalva are at increased risk of urinary retention following MUS placement.
一部分神经功能正常的女性通过有效的瓦尔萨尔瓦动作排尿，而非逼尿肌收缩。我们确定了在通过逼尿肌收缩排尿与通过瓦尔萨尔瓦动作排尿的女性中，放置尿道中段吊带（MUS）后尿潴留的发生率。
对2002年至2009年间因尿动力学压力性尿失禁接受MUS植入的患者进行回顾性研究。排除同时进行盆腔手术、既往有尿失禁手术史或术前膀胱排空不完全的女性。根据术前尿动力学检查结果将患者分为两组——通过逼尿肌收缩压>10厘米水柱排尿的患者和通过瓦尔萨尔瓦动作排尿的患者。
107例患者可供分析。瓦尔萨尔瓦动作组和非瓦尔萨尔瓦动作组术后尿潴留率分别为22%和5%（p<0.05）。每组的平均潴留持续时间为3周（范围1 - 6周）。
通过瓦尔萨尔瓦动作排尿的女性在放置MUS后发生尿潴留的风险增加。
