[女性尿道口畸形与尿道下裂：患病率、问题及定义。对12739例患者的研究]

Salga M, Guinet-Lacoste A, Demans-Blum C, Thomas-Pohl M, Weglinski L, Amarenco G

Service de neuro-urologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France.

Sorbonne universités, UPMC université Paris 06, GRC 01, GREEN, Group of Clinical Research in Neuro-Urology, 75005 Paris, France; Service de neuro-urologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France.

Prog Urol. 2014 Dec;24(17):1093-8. doi: 10.1016/j.purol.2014.10.005. Epub 2014 Nov 13.

UNLABELLED

The difficulty to access to the urethral meatus is found in women in relation to morphological abnormalities of urogenital or ectopic locations meatus, whether acquired (urethral meatus buried [UMB]) or congenital reality (urethra hypospadias [UH]). The pathophysiology is not unequivocal with lack of clear and specific studies.

PURPOSE

Verify the existence of specific functional problems, assess the prevalence and identify the anatomical features of UMB and UH.

MATERIALS

UMB and UH were sought in a computerized database listing the patients attending a neurourology department between 2000 and 2014 for a pelvic-perineal disease. Each case was analysed for specific reached leaks, urinary tract infections and difficulties catheterization.

RESULTS

Of the 12,739, 131 patients (1%) met the inclusion criteria, including 18 UH and 113 UMB. Ninety-one patients consulted for urinary disorders of neurological origin. The circumstances of UMB and UH discovery were: perineal systematic review in 63 cases (48%); difficulties of urethral catheterization in 65 cases (49%); urinary incontinence for 3 patients (3%). Urinary tract infections have not led to the discovery of UMB or UH. Difficulties locating the urethral meatus were congenital (UH) in 18 cases (13%). In 113 cases (87%), it was an acquired abnormality (UMB) overweight for 16 patients (12%), troublesome spasticity of the adductor muscles in 18 cases (14%), vulvovaginal atrophy in 5 cases (4%) and a patient (1%) with a pelvic organ prolapse. No details were given for the remaining 72 patients (54%).

CONCLUSION

The urethral meatus difficult access due to MUE or UH can be met in a specialized service but the exact concept of MUE be defined. It can be considered as urethral meatus difficult to access and the cause is acquired. Functional impairment may be particularly important in patients requiring catheterization for bladder emptying.

LEVEL OF EVIDENCE

未标注

在女性中，由于泌尿生殖系统形态异常或尿道口异位，无论是后天性（尿道口埋没[UMB]）还是先天性（尿道下裂[UH]），都存在尿道口难以暴露的情况。由于缺乏明确且具体的研究，其病理生理学尚不明确。

目的

验证特定功能问题的存在，评估患病率，并确定UMB和UH的解剖特征。

材料

在一个计算机化数据库中查找UMB和UH，该数据库列出了2000年至2014年间因盆腔 - 会阴疾病就诊于神经泌尿外科的患者。对每个病例分析特定的尿失禁、尿路感染和导尿困难情况。

结果

在12739名患者中，131名（1%）符合纳入标准，包括18例UH和113例UMB。91名患者因神经源性泌尿系统疾病就诊。发现UMB和UH的情况如下：63例（48%）是通过会阴系统检查发现；65例（49%）是由于尿道导尿困难发现；3例（3%）是因尿失禁发现。尿路感染未导致UMB或UH的发现。18例（13%）尿道口定位困难是先天性（UH）。113例（87%）是后天性异常（UMB），其中16例（12%）超重，18例（14%）内收肌痉挛严重，5例（4%）外阴阴道萎缩，1例（1%）盆腔器官脱垂。其余72例（54%）未给出详细情况。