Bu Lan, Yang Dan, Nie Fang, Li Qi, Wang Yan-Fang
Department of Medical Ultrasonics, Lanzhou University Second Hospital, No. 82, Cuiyingmen, Chengguan District, Lanzhou, 730030, Gansu, China.
J Med Ultrason (2001). 2020 Jan;47(1):123-130. doi: 10.1007/s10396-019-00972-0. Epub 2019 Sep 6.
To assess the correlation between the type and degree of cystocele and stress urinary incontinence (SUI) by transperineal ultrasound.
A retrospective study evaluated 207 women who were diagnosed with cystocele by transperineal ultrasound. One hundred and six women who were diagnosed with SUI by a full urodynamic study were enrolled in the SUI group, 101 women without SUI were enrolled in the prolapse group, and 100 normal women with neither SUI nor POP were enrolled as the control group. In the transperineal ultrasound study, the bladder neck, the lowest point of the bladder wall, bladder neck funneling, the retrovesical angle, and the urethra inclination angle were observed at rest and Valsalva.
It was found that 87.7% of patients in the SUI group were diagnosed with cystourethrocele, which was significantly higher than the 47.5% in the prolapse group. In addition, 93.4% of patients in the SUI group were diagnosed with Grade I or II cystocele and 6.6% were Grade III, which was significantly higher than that in the prolapse group. Bladder neck funneling on ultrasonography had a sensitivity of 59.4% and a specificity of 64.1% for the detection of SUI. It was significantly higher in cystourethrocele than isolated cystocele (P < 0.05).
The type and degree of cystocele can be diagnosed by transperineal ultrasound. Cystourethrocele and bladder neck funneling are highly correlated with SUI. Bladder neck funneling may be an important symptom of SUI.
通过经会阴超声评估膀胱膨出的类型和程度与压力性尿失禁(SUI)之间的相关性。
一项回顾性研究评估了207例经会阴超声诊断为膀胱膨出的女性。106例经全面尿动力学检查诊断为SUI的女性纳入SUI组,101例无SUI的女性纳入脱垂组,100例既无SUI也无盆腔器官脱垂(POP)的正常女性作为对照组。在经会阴超声检查中,于静息状态和Valsalva动作时观察膀胱颈、膀胱壁最低点、膀胱颈漏斗形成、膀胱后角和尿道倾斜角。
发现SUI组中87.7%的患者被诊断为膀胱尿道膨出,显著高于脱垂组的47.5%。此外,SUI组中93.4%的患者被诊断为I度或II度膀胱膨出,6.6%为III度,显著高于脱垂组。超声检查中膀胱颈漏斗形成对SUI检测的敏感性为59.4%,特异性为64.1%。膀胱尿道膨出中的该指标显著高于单纯膀胱膨出(P < 0.05)。
经会阴超声可诊断膀胱膨出的类型和程度。膀胱尿道膨出和膀胱颈漏斗形成与SUI高度相关。膀胱颈漏斗形成可能是SUI的一个重要症状。