Lu R, Zhang Y, Dai F R, Yu Y P
Department of gynecology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China.
Zhonghua Yi Xue Za Zhi. 2018 Sep 4;98(33):2675-2677. doi: 10.3760/cma.j.issn.0376-2491.2018.33.013.
To explore the application of transperineal pelvic floor ultrasonography in the diagnosis of female stress urinary incontinence(SUI). From March 2017 to December 2017, 60 patients diagnosed with SUI by department of gynecology, Xiangya Hospital of Central South University were selected as the case group, and 30 cases of normal women in the same period were selected as the control group. All subjects in both groups were examined by transperineal pelvic floor ultrasonography, that is, to be measured the bladder neck descent(BND), the urethral inclination angle(UIA), the posterior urethrovesical angle(PUVA) and the levator hiatus area(LHA) in resting state and during Valsalva maneuver. (1)The differences in the measured values of the two groups were statistically significant(<0.05). (2)The receiver operating characteristic curve(ROC) was used to find the cut-off values of SUI: when BND>31.5 mm; in Valsalva state, UIA>33.5°, PUVA>150.5° and LHA>20.6 cm with their sensitivity of 77.6%, 71.4%, 68.3% and 61.4%, respectively; the specificity of 68.9%, 74.6%, 73.9% and 78.0%, respectively. The area under the curve(AUC) were 0.753, 0.812, 0.721 and 0.712, respectively, when combined analysis of these indexes, reaching to 0.912. (1) Transperineal pelvic floor ultrasonography has a certain diagnostic value for SUI. (2)Combined analysis of various ultrasonic parameters can significantly improve the diagnostic efficiency of SUI.
探讨经会阴盆底超声检查在女性压力性尿失禁（SUI）诊断中的应用。选取2017年3月至2017年12月在中南大学湘雅医院妇科确诊为SUI的60例患者作为病例组，同期选取30例正常女性作为对照组。两组所有受试者均行经会阴盆底超声检查，即在静息状态和Valsalva动作时测量膀胱颈下移（BND）、尿道倾斜角（UIA）、后尿道膀胱角（PUVA）及肛提肌裂孔面积（LHA）。（1）两组测量值差异有统计学意义（<0.05）。（2）采用受试者操作特征曲线（ROC）确定SUI的截断值：当BND>31.5 mm；在Valsalva状态下，UIA>33.5°、PUVA>150.5°及LHA>20.6 cm时，其敏感性分别为77.6%、71.4%、68.3%及61.4%；特异性分别为68.9%、74.6%、73.9%及78.0%。这些指标联合分析时曲线下面积（AUC）分别为0.753、0.812、0.721及0.712，联合后达0.912。（1）经会阴盆底超声检查对SUI有一定诊断价值。（2）多种超声参数联合分析可显著提高SUI的诊断效率。
