Chelsea and Westminster NHS Foundation Trust, London, UK.
Imperial College London, London, UK.
Int Urogynecol J. 2020 Dec;31(12):2589-2594. doi: 10.1007/s00192-020-04409-y. Epub 2020 Jul 1.
To compare urethral sphincter measurements in women with different urodynamic diagnoses using three-dimensional transperineal ultrasound (TPU).
Women with lower urinary tract dysfunction having urodynamic studies (UDS) were prospectively recruited to this study. A detailed history and vaginal examination were conducted. Saline cystometry was performed and the women were divided into groups according to their urodynamic diagnosis, which were nondiagnostic urodynamics (NUDS), pure detrusor overactivity (PureDO), pure urodynamic stress incontinence (PureUSI) and mixed urinary incontinence (MUDS). Three-dimensional TPU was performed to measure total urethral sphincter volume, striated sphincter volume, core volume, sphincter length and maximum cross-sectional area. The ultrasound measurements were compared with the diagnostic urodynamics.
One hundred fifty women were included in the study. There were 37, 53, 22 and 38 women in the groups of NUDS, PureDO, PureUSI and MUDS respectively. The average striated sphincter volumes in these groups were 1.84 ml, 2.24 ml, 1.32 ml and 1.98 ml respectively. There was no difference in average age, body mass index or presence of prolapse in these groups. All measurements were larger in the PureDO and smaller in the PureUSI group compared with the NUDS group. The measurements in the MUDS group were larger than in the NUDS group and smaller than in the PureDO group but this difference was not statistically significant.
The urethral sphincter of women with PureDO is larger than in women with PureUSI. The value in women with MUDS was between the two. The size of the urethral sphincter appears to be related to the pathophysiology.
使用三维经会阴超声（TPU）比较不同尿动力学诊断的女性尿道括约肌测量值。
本研究前瞻性招募了患有下尿路功能障碍且进行尿动力学研究（UDS）的女性。进行了详细的病史和阴道检查。进行了生理盐水膀胱测压，并根据尿动力学诊断将女性分为非诊断性尿动力学（NUDS）、单纯逼尿肌过度活动（PureDO）、单纯尿动力学压力性尿失禁（PureUSI）和混合性尿失禁（MUDS）组。进行三维 TPU 以测量总尿道括约肌体积、横纹肌体积、核心体积、括约肌长度和最大横截面积。将超声测量值与诊断性尿动力学进行比较。
本研究共纳入 150 名女性。NUDS、PureDO、PureUSI 和 MUDS 组分别有 37、53、22 和 38 名女性。这些组的平均横纹肌体积分别为 1.84 ml、2.24 ml、1.32 ml 和 1.98 ml。这些组的平均年龄、体重指数或脱垂存在均无差异。与 NUDS 组相比，PureDO 和 PureUSI 组的所有测量值均较大，而 PureUSI 组的所有测量值均较小。MUDS 组的测量值大于 NUDS 组，小于 PureDO 组，但差异无统计学意义。
PureDO 女性的尿道括约肌大于 PureUSI 女性。MUDS 女性的值介于两者之间。尿道括约肌的大小似乎与病理生理学有关。
