Heydari Fatemeh, Motaghed Zahra, Abbaszadeh Shahin
Assistant Professor, Department of Urology, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran.
M.D, Department of Urology, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Electron Physician. 2017 Jun 25;9(6):4678-4682. doi: 10.19082/4678. eCollection 2017 Jun.
Stress Urinary Incontinence (SUI) is one of the most reported health dilemmas of women suffering from lower urinary tract symptoms.
To determine the relation between hysterectomy and severity of female SUI using Valsalva Leak Point Pressure (VLPP).
This case-control study was conducted at a public urology clinic in Tehran in 2015. The study population was all female with SUI complaints who visited the clinic during 2015. We compared Valsalva leak point pressure in two groups of female SUI patients with and without hysterectomy history. The inclusion criteria were: not taking any alpha-blocker or anti-cholinergic medicines two weeks prior to the urodynamic test as well as no history of pelvic surgery or cesarean delivery in their lifetime. All qualified patients were invited to participate in the study randomly, and among them, 120 qualified patients agreed to participate by filling out the informed consent form. Data was gathered through direct interview, and double checked by patients' medical records. All the study variables including age, BMI, delivery number, hysterectomy and UTI history were entered and analyzed by estimating ordered logistic regression and by using Stata14.1 software.
The mean of VLPP was 70.17 cmHO in the group with hysterectomy history, and 94.55 cmHO in those without hysterectomy history. The difference of VLPP pressure between the two studied groups were significant (p<0.05), even after control of confounding variables. Also, the odds of severe SUI among hysterectomy group patients was 6.3 times more than no hysterectomy (OR=6.32, p<0.001).
Our study confirms significant relation between hysterectomy and SUI severity measured by Valsalva leak point pressure. Hysterectomy patients are more likely to suffer from more severe grades of SUI.
压力性尿失禁（SUI）是下尿路症状女性中报告最多的健康难题之一。
使用瓦尔萨尔瓦漏尿点压力（VLPP）确定子宫切除术与女性SUI严重程度之间的关系。
本病例对照研究于2015年在德黑兰的一家公共泌尿外科诊所进行。研究人群为2015年期间到该诊所就诊的所有有SUI主诉的女性。我们比较了两组有和无子宫切除术史的女性SUI患者的瓦尔萨尔瓦漏尿点压力。纳入标准为：在尿动力学检查前两周未服用任何α受体阻滞剂或抗胆碱能药物，且一生中无盆腔手术或剖宫产史。所有符合条件的患者被随机邀请参加研究，其中120名符合条件的患者通过填写知情同意书同意参加。数据通过直接访谈收集，并由患者的病历进行二次核对。所有研究变量，包括年龄、体重指数、分娩次数、子宫切除术和尿路感染史，通过估计有序逻辑回归并使用Stata14.1软件进行录入和分析。
有子宫切除术史的组中VLPP的平均值为70.17 cmH₂O，无子宫切除术史的组中为94.55 cmH₂O。即使在控制混杂变量后，两个研究组之间的VLPP压力差异仍具有统计学意义（p<0.05）。此外，子宫切除组患者中重度SUI的几率比未行子宫切除术的患者高6.3倍（OR=6.32，p<0.001）。
我们的研究证实了子宫切除术与通过瓦尔萨尔瓦漏尿点压力测量的SUI严重程度之间存在显著关系。子宫切除患者更有可能患更严重等级的SUI。
