改变泌尿生殖系统脱垂的评估方法
Ringing the changes in evaluation of urogenital prolapse.
作者信息
Srikrishna Sushma, Robinson Dudley, Cardozo Linda
机构信息
Department of Urogynaecology, King's College Hospital, Denmark Hill, London, SE5 9RS, UK.
出版信息
Int Urogynecol J. 2011 Feb;22(2):171-5. doi: 10.1007/s00192-010-1253-7. Epub 2010 Sep 7.
INTRODUCTION AND HYPOTHESIS
Some women with pelvic organ prolapse (POP) have occult urodynamic stress incontinence (OUSI) and might develop incontinence after POP surgery. Our aim was to determine predictive value of ring pessary test during urodynamics in identifying patients with OUSI, likely to develop stress urinary incontinence (SUI) postoperatively.
METHODS
Women with POP were recruited from surgical lists. All underwent preoperative videocystourethrography (VCU). Women with normal VCUs had tests repeated after pessary reduction of POP.
RESULTS
One hundred and twelve women were studied. Forty-eight women had "normal" VCU. Of these, 43 had no OUSI and only 1/43 developed SUI postoperatively. Five women had OUSI and 2/5 developed frank SUI. The pessary test had poor sensitivity (67%) but high specificity (93%) in predicting postoperative SUI. Positive predictive value was low (40%), with an excellent negative predictive value (98%).
CONCLUSION
This test can identify patients likely to remain continent following surgery and be a valuable tool in preoperative counselling.
引言与假设
一些盆腔器官脱垂（POP）女性存在隐匿性尿动力学压力性尿失禁（OUSI），且在POP手术后可能会出现尿失禁。我们的目的是确定尿动力学检查期间环形子宫托试验在识别OUSI患者方面的预测价值，这些患者术后可能发生压力性尿失禁（SUI）。
方法
从手术名单中招募POP女性。所有患者均接受术前膀胱尿道造影（VCU）。VCU正常的女性在子宫托复位POP后重复进行检查。
结果
共研究了112名女性。48名女性VCU“正常”。其中，43名无OUSI，术后仅1/43发生SUI。5名女性有OUSI，2/5发生明显SUI。子宫托试验预测术后SUI的敏感性较差（67%），但特异性较高（93%）。阳性预测值较低（40%），阴性预测值极佳（98%）。
结论
该检查可识别术后可能保持控尿的患者，是术前咨询的一项有价值工具。
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