Grischke E M, Heinrich D, Auer L, Kubli F
Univ.-Frauenklinik Heidelberg.
Geburtshilfe Frauenheilkd. 1987 Oct;47(10):707-12. doi: 10.1055/s-2008-1036029.
The present paper describes a test center which permits urodynamics tests with the patient in various positions, such as lithotomy position (A), supine position with outstretched legs (B) and, by continuously raising the patient, upright position (C). The results of a comparative investigation show the influence of these different examination positions on urodynamic parameters, in particular the functional length of the urethra and maximum urethra closing pressure at rest. Urodynamic tests on 40 patients with urinary incontinence showed that there is a significant increase in the functional length of the urethra when the patient is in lithotomy position (A) as compared to lying with outstretched legs (B), and that it is once again significantly reduced when the patient is raised to upright position. Maximum urethra closing pressure at rest drops significantly when the patient is repositioned from lithotomy (A) to supine (B) position, and once again rises significantly when she is raised to the upright (C) as compared to the supine (B) position. In the light of the changes described, which cause major changes in the form of the urethra pressure profile, it makes sense to perform urodynamic measurements in at least two different positions. The authors recommend the supine position with outstretched legs (B), as it appears more physiological than the lithotomy position (A), and measurement in the upright position (C). The importance of positioning with regard to the diagnostic information value in determining the cause of urinary incontinence is discussed.
本文介绍了一个测试中心，该中心允许患者在不同体位下进行尿动力学测试，如截石位（A）、双腿伸直仰卧位（B），以及通过持续抬高患者形成直立位（C）。一项对比研究的结果显示了这些不同检查体位对尿动力学参数的影响，尤其是尿道的功能长度和静息时的最大尿道闭合压。对40例尿失禁患者进行的尿动力学测试表明，与双腿伸直仰卧（B）位相比，患者处于截石位（A）时尿道功能长度显著增加，而当患者被抬高至直立位时，尿道功能长度再次显著缩短。当患者从截石位（A）重新调整为仰卧位（B）时，静息时的最大尿道闭合压显著下降，与仰卧位（B）相比，当患者被抬高至直立位（C）时，最大尿道闭合压再次显著升高。鉴于上述变化会导致尿道压力曲线形态发生重大改变，因此在至少两个不同体位下进行尿动力学测量是有意义的。作者推荐双腿伸直仰卧位（B），因为它看起来比截石位（A）更符合生理状态，并建议在直立位（C）进行测量。文中还讨论了体位对于确定尿失禁病因时诊断信息价值的重要性。
