尿道在有控和无控女性膀胱充盈时如何反应？

How Does the Urethra Respond to Bladder Filling in Continent and Incontinent Women?

机构信息

From the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL.

出版信息

Female Pelvic Med Reconstr Surg. 2022 May 1;28(5):321-324. doi: 10.1097/SPV.0000000000001125. Epub 2021 Dec 3.

DOI:10.1097/SPV.0000000000001125

PMID:34864751

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9169549/

Abstract

OBJECTIVE

The objective of this study was to describe mean urethral pressure (MUP) during filling cystometry in continent and incontinent women.

METHODS

Incontinent women were recruited from a urogynecology clinic if they answered "sometimes" or "always" to 1 of the items on the Medical, Epidemiologic, and Social Aspects of Aging questionnaire. Participants were categorized by Medical, Epidemiologic, and Social Aspects of Aging scores into stress urinary incontinence (SUI) or urgency urinary incontinence (UUI) groups. Continent women were recruited from the community. Multichannel urodynamics were performed using microtip catheters. Urethral pressure profiles were obtained with an empty bladder and at 100-mL increments during filling. Data were analyzed in SPSS. Continuous variables were compared with independent t test or analysis of variance, categorical variables with the χ2 test, and multivariable comparisons were made with linear regression.

RESULTS

Eighty-six women (30 continent, 56 incontinent: 37 SUI, 19 UUI) with a mean ± SD age of 48 ± 15 years and a body mass index (BMI) of 31 ± 9 participated. Sixty-nine percent were White, 43% were postmenopausal, and 80% were parous. Continent women were younger (P < 0.001) and had a lower BMI (P = 0.004). Mean cystometric capacity was higher in women with SUI and continent women than in women with UUI (430 ± 142, 448 ± 101, and 332 ± 160, P = 0.04). Continent women had higher MUP at baseline when controlling for age, BMI, and parity (84 ± 35 cmH2O vs 62 ± 28 cmH2O; aR2 = 0.2, P = 0.02) compared with incontinent women. During filling, MUP in continent women was 20-30 cmH2O higher at all bladder volumes than incontinent women. Mean urethral pressure increased significantly between baseline and 300 mL in continent women (P < 0.005) and women with SUI (P = 0.04), but not in women with UUI (P = 0.48).

CONCLUSIONS

Continent women have greater baseline MUP and greater increases in MUP during bladder filling than incontinent women.

摘要

目的

本研究旨在描述充盈性膀胱测压期间逼尿肌压力（MUP）在控尿和尿失禁女性中的变化。

方法

从尿失禁门诊招募尿失禁女性，如果她们对老龄化医学、流行病学和社会方面问卷中的 1 项回答“有时”或“总是”，则将其归入研究。根据老龄化医学、流行病学和社会方面问卷评分，将参与者分为压力性尿失禁（SUI）或急迫性尿失禁（UUI）组。从社区招募控尿女性。使用微尖导管进行多通道尿动力学检查。在排空膀胱和以 100ml 递增的充盈过程中获得尿道压力曲线。数据分析采用 SPSS。连续变量采用独立 t 检验或方差分析比较，分类变量采用卡方检验，多变量比较采用线性回归。

结果

共 86 名女性（30 名控尿，56 名尿失禁：37 名 SUI，19 名 UUI）参与研究，平均年龄（±标准差）为 48±15 岁，体重指数（BMI）为 31±9。69%为白人，43%为绝经后，80%为经产妇。控尿女性更年轻（P<0.001），BMI 更低（P=0.004）。SUI 和控尿女性的膀胱测压容量明显高于 UUI 女性（分别为 430±142ml、448±101ml 和 332±160ml，P=0.04）。在控制年龄、BMI 和产次后，控尿女性的基础 MUP 高于尿失禁女性（84±35cmH2O 比 62±28cmH2O；aR2=0.2，P=0.02）。在充盈过程中，与尿失禁女性相比，控尿女性在所有膀胱容量时的 MUP 均高 20-30cmH2O。控尿女性在基础值和 300ml 时 MUP 显著增加（P<0.005），SUI 女性也有显著增加（P=0.04），但 UUI 女性没有显著增加（P=0.48）。