The Second Xiangya Hospital, Central South University, Changsha, China.
Nepean Clinical School, University of Sydney, Sydney, NSW, Australia.
Ultrasound Obstet Gynecol. 2019 Jan;53(1):124-128. doi: 10.1002/uog.19165.
To evaluate changes in urethral mobility and configuration after prolapse repair.
This was a retrospective study of 92 patients who were examined between 2005 and 2016 before and after surgery for pelvic organ prolapse (POP) without concomitant anti-incontinence surgery. All patients were assessed with an interview, POP quantification and translabial four-dimensional ultrasound. Urethral mobility was evaluated using semi-automated urethral motion profile software in which x- and y-coordinates of six equidistant points along the length of the urethra were determined both at rest and on Valsalva, relative to the posteroinferior margin of the pubic symphysis. Urethral kinking was measured by placing tangents distal and proximal to any visually identified change in the urethral axis. Imaging data obtained before and after prolapse surgery were compared.
Mean age was 58 years and mean follow-up was 5.8 months. Prolapse symptoms had resolved in 85% of patients. Highly significant reductions in urethral mobility and urethral kinking were seen after surgery (all P ≤ 0.001). Similar changes were observed after anterior vaginal repair with or without apical repair, without concomitant posterior repair (n = 23; all P < 0.05).
POP surgery was associated significantly with 'straightening' of the urethra and reduction in urethral mobility. The effect seems to be due largely to cystocele repair. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
评估脱垂修复后尿道活动度和形态的变化。
这是一项回顾性研究，共纳入 92 例因盆腔器官脱垂（POP）于 2005 年至 2016 年期间行手术治疗而无同时行抗失禁手术的患者。所有患者均通过访谈、POP 定量和经阴道四维超声检查进行评估。采用半自动化尿道运动轮廓软件评估尿道活动度，该软件可确定静止和valsalva 动作时尿道长度上 6 个等距点的 x 和 y 坐标，相对于耻骨联合后下边缘。通过在任何视觉上识别的尿道轴变化的远端和近端放置切线来测量尿道扭曲。比较脱垂手术前后的影像学数据。
患者的平均年龄为 58 岁，平均随访时间为 5.8 个月。85%的患者脱垂症状得到缓解。手术后尿道活动度和尿道扭曲明显降低（均 P≤0.001）。在前阴道修复术（伴或不伴顶端修复术）而无同期后修补术时也观察到类似的变化（n=23；均 P<0.05）。
POP 手术与尿道“变直”和尿道活动度降低显著相关。这种效应似乎主要归因于膀胱膨出的修复。版权所有 © 2018 ISUOG。由 John Wiley & Sons Ltd 出版。
