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[压力性尿失禁女性尿道压力测定的扩展分析——初步报告]

[Extended analysis of urethral profilometry in women with urinary stress incontinence--preliminary report].

作者信息

Witek Andrzej, Nowara Adam, Prajsner Andrzej, Mikuś Karolina, Wróbel Ewa

机构信息

Katedra i Klinika Połoinictwa i Ginekologii Slaskiego Uniwersytetu Medycznego w Katowicach.

出版信息

Ginekol Pol. 2010 Aug;81(8):582-7.

Abstract

UNLABELLED

Stress urinary incontinence (SUI) is the most common kind of urinary incontinence in women. Treatment efficiency depends on the type of stress urinary incontinence.

OBJECTIVES

The purpose of the following study was to compare certain urethral profilometry parameters, including additional ones, in women with stress urinary incontinence (type 0) and women categorized as a 'transitional group' who were likely to have the mechanism of the intrinsic sphincter deficiency in pathogenesis of SUI.

MATERIAL AND METHODS

Examinations included 100 patients with diagnosed SUI based on medical history clinical evaluation, pad test and urodynamic evaluation. Studied population was divided into three groups depending on the presence of leakage and VLPP value in the urodynamic test. The first group consisted of 19 patients with no leakage during urodynamic test (with SUI type 0), the second group (2) comprised 30 patients with VLPP 60-89 cmH2O and the third group included 36 patients with VLPP > or =90 cmH2O. 15 patients with leakage appearing at VLPP <60 cmH2O were excluded from the study The final analysis was carried out in a group of 85 patients. The analysed urethral profilometry parameters included: (MUCP, cmH2O), (Total Profile Area, cmH2O mm), (Profile Length to Peak, mm), (Proximal Area to Peak cmH2O mm), (Distal Area after Peak, cmH2O mm)

RESULTS

Most of the analyzed urethral profilometry parameters, excluding Profile Length to Peak, in the group of patients with VLPP 60-89 cmH20 have revealed significantly lower values of MUCP than in the group with no leakage. No significant differences of the analyzed parameters between group 1 and group 3 and between group 2 and group 3 have been revealed although their values were slightly elevated in the group of patients with critical VLPP.

CONCLUSION

Lower values of fields under the urethral profilometry curve can suggest a greater urethral closing mechanism deficiency and the coexistence of the external sphincter insufficiency This parameter can be very useful in the group of patients with moderate leakage point.

摘要

未标注

压力性尿失禁(SUI)是女性中最常见的尿失禁类型。治疗效果取决于压力性尿失禁的类型。

目的

以下研究的目的是比较压力性尿失禁(0型)女性和被归类为“过渡组”的女性的某些尿道压力测定参数,包括其他参数,这些“过渡组”女性在SUI发病机制中可能存在内在括约肌缺陷机制。

材料与方法

检查包括100例根据病史、临床评估、尿垫试验和尿动力学评估确诊为SUI的患者。根据尿动力学试验中漏尿情况和腹压漏尿点压力(VLPP)值,将研究人群分为三组。第一组由19例尿动力学试验期间无漏尿的患者组成(0型SUI),第二组(2)包括30例VLPP为60 - 89 cmH₂O的患者,第三组包括36例VLPP≥90 cmH₂O的患者。15例VLPP<60 cmH₂O时出现漏尿的患者被排除在研究之外。最终分析在一组85例患者中进行。分析的尿道压力测定参数包括:(最大尿道闭合压,cmH₂O)、(总压力分布面积,cmH₂O·mm)、(压力分布长度至峰值,mm)、(近端压力分布面积至峰值,cmH₂O·mm)、(峰值后远端压力分布面积,cmH₂O·mm)

结果

在VLPP为60 - 89 cmH₂O的患者组中,除压力分布长度至峰值外,大多数分析的尿道压力测定参数显示最大尿道闭合压值显著低于无漏尿组。虽然在临界VLPP患者组中这些参数值略有升高,但未发现第1组和第3组之间以及第2组和第3组之间分析参数的显著差异。

结论

尿道压力测定曲线下区域值较低可能提示尿道闭合机制缺陷更大以及外括约肌功能不全并存。该参数在中度漏尿点患者组中可能非常有用。

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