Beck R P, McCormick S, Nordstrom L
Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Canada.
Obstet Gynecol. 1988 Sep;72(3 Pt 1):302-6.
Cough-pressure spike differences between the urethra and bladder were compared before and after surgery that cured genuine stress incontinence in 267 women. In 97.4% of 151 patients cured by a fascia lata sling procedure, the urethralvesical cough-pressure transmission ratio was greater than 100%, and in no case was it less than 100%. In 46.6% of 116 patients cured by anterior colporrhaphy, the cough-pressure transmission ratio was greater than 100%, and in 20.7% of the 116 patients, the transmission ratio was less than 100%. The 24 women in the latter group were cured by a sufficient increase in resting intraurethral pressure (to augment the maximal intraurethral closure pressure with stress) to maintain continence with increased intra-abdominal pressure. We believe that urethral kinking at the instant of increased intra-abdominal pressure with stress produced the greater than 100% cough-pressure transmission ratio seen in 201 (75.3%) of the 267 patients cured of genuine stress incontinence.
对267例真性压力性尿失禁治愈的女性患者，比较了手术前后尿道和膀胱咳嗽压力峰值的差异。在151例采用阔筋膜吊带手术治愈的患者中，97.4%的患者尿道膀胱咳嗽压力传递率大于100%，无一例低于100%。在116例采用阴道前壁修补术治愈的患者中，46.6%的患者咳嗽压力传递率大于100%，116例患者中有20.7%的患者传递率低于100%。后一组的24名女性通过充分增加静息尿道内压（以增加应激时的最大尿道内闭合压）治愈，从而在腹内压增加时保持控尿。我们认为，在267例真性压力性尿失禁治愈的患者中，201例（75.3%）患者在应激时腹内压增加瞬间出现的尿道扭结导致咳嗽压力传递率大于100%。
