Guerquin B
Service de gynécologie-obstétrique, centre hospitalier d'Orange (84100), avenue de Lavoisier, CS20184, 84104 Orange cedex, France.
J Gynecol Obstet Biol Reprod (Paris). 2015 Sep;44(7):591-6. doi: 10.1016/j.jgyn.2015.03.001. Epub 2015 Apr 9.
Improving the understanding of the adaptation to stress of urinary continence.
A transversal analysis between physics of materials and the female anatomy. Laws of physics of the materials and of their viscoelastic behavior are applied to the anatomy of the anterior vaginal wall.
The anterior vaginal wall may be divided into two segments of different viscoelastic behavior, the vertical segment below the urethra and the horizontal segment below the bladder. If the urethra gets crushed on the first segment according to the hammock theory, the crushing of the bladder on the second segment is, on the other hand, damped by its important elasticity. The importance of this elasticity evokes an unknown function: damping under the bladder that moderates and delays the increase of intravesical pressure. This damping function below the bladder is increased in the cystocele, which is therefore a continence factor; on the other hand, it is impaired in obesity, which is therefore a factor of SUI.
It is necessary to include in the theory of stress continence, the notion of a damping function below the bladder.
增进对尿失禁应激适应的理解。
对材料物理学与女性解剖学进行横向分析。将材料的物理学定律及其粘弹性行为应用于阴道前壁的解剖结构。
阴道前壁可分为具有不同粘弹性行为的两个部分，尿道下方的垂直部分和膀胱下方的水平部分。根据吊床理论，如果尿道在第一部分受到挤压，另一方面，膀胱在第二部分的挤压会因其重要的弹性而受到缓冲。这种弹性的重要性引发了一种未知功能：在膀胱下方起到缓冲作用，缓和并延迟膀胱内压的升高。膀胱下方的这种缓冲功能在膀胱膨出时增强，因此是一种控尿因素；另一方面，在肥胖症中该功能受损，因此是压力性尿失禁的一个因素。
在压力性尿失禁理论中，有必要纳入膀胱下方缓冲功能这一概念。
