Chapple C R, Helm C W, Blease S, Milroy E J, Rickards D, Osborne J L
Department of Urology, Middlesex Hospital, London.
Br J Urol. 1989 Oct;64(4):357-9. doi: 10.1111/j.1464-410x.1989.tb06042.x.
This study investigated 29 nulliparous women using the technique of transvaginal ultrasound to assess whether their bladder necks were open or closed at rest. The patients comprised 2 groups: 4 reported occasional episodes of stress incontinence, all of whom had closed bladder necks; the remaining 25 patients were totally asymptomatic. Overall a 21% incidence of an open bladder neck was recorded. It is likely that the true incidence of open bladder necks in young nulliparous women is higher than this, since none of these patients had troublesome stress incontinence. Since women with open bladder necks are more likely to develop stress incontinence if the integrity of the distal sphincter mechanism is compromised by neural damage, antenatal recognition of this problem should provide a contraindication to traumatic vaginal delivery and may in the future reduce the incidence of symptomatic stress incontinence in the population.
本研究采用经阴道超声技术对29名未生育女性进行了调查，以评估她们静息时膀胱颈是开放还是闭合状态。患者分为两组：4名报告偶尔有压力性尿失禁发作，她们的膀胱颈均为闭合状态；其余25名患者完全无症状。总体而言，记录到膀胱颈开放的发生率为21%。年轻未生育女性中膀胱颈开放的实际发生率可能高于此，因为这些患者中没有一人有严重的压力性尿失禁。由于如果远端括约肌机制的完整性因神经损伤而受损，膀胱颈开放的女性更有可能发生压力性尿失禁，产前识别这一问题应为创伤性阴道分娩提供禁忌证，并且未来可能会降低人群中有症状的压力性尿失禁的发生率。
