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一项关于产后9至18个月初产妇中,通过超声测量的尿道活动过度与压力性尿失禁症状之间关系的评估。

An assessment of the relationship between urethral hypermobility as measured by ultrasound and the symptoms of stress urinary incontinence in primiparous women 9-18 months postpartum.

作者信息

Pająk Paulina Maria, Wlaźlak Edyta, Surkont Grzegorz, Kalinka Jarosław

机构信息

Department of Perinatology, 1st Department of Gynecology and Obstetrics, Medical University of Lodz, Lodz, Poland.

Department of Operative Gynecology and Gynecologic Oncology, 1st Department of Gynecology and Obstetrics, Medical University of Lodz, Lodz, Poland.

出版信息

J Ultrason. 2024 Mar 14;24(96):20240010. doi: 10.15557/jou.2024.0010. eCollection 2024 Feb.

Abstract

AIM

The aim of the study was to estimate the relationship between bladder neck hypermobility as assessed by ultrasound and the occurrence of stress urinary incontinence as measured with the UDI-6 questionnaire in primiparous women 9-18 months postpartum.

MATERIALS AND METHODS

The study included 100 women 9-18 months after their first delivery, 19% of whom (study group) presented with urethral hypermobility. Ultrasound was used to determine the position and mobility of the bladder neck in order to assess the urethral hypermobility. A vector of ≥15 mm was defined as urethral hypermobility. Symptoms of stress urinary incontinence were assessed using question 3 of the UDI-6 questionnaire, in which the presence of symptoms was defined as a response rated from 1 to 4.

RESULTS

We demonstrated a statistically significant relationship between urethral hypermobility and the symptoms of stress urinary incontinence with a statistical significance level of <0.002.

CONCLUSIONS

Stress urinary incontinence is a common disorder in women, the pathophysiology of which is not fully understood. It has adverse effects on the quality of life, perception of one's own body and sexual function. Impairment of urethral fixation may play an important role in the pathophysiology of this common form of urinary incontinence. The study showed that urethral hypermobility, as assessed by ultrasound, contributes to stress urinary incontinence, as measured with the UDI-6 score. Although stress urinary incontinence is a multifactorial disorder influenced by anatomical changes and congenital anatomical features, it is easily diagnosed. Suburethral slings are an effective surgical technique; however, the incidence of postoperative voiding dysfunction or recurrent stress urinary incontinence is 10-20%. Therefore, an assessment of anatomical changes in stress urinary incontinence may help individualize the surgical strategy.

摘要

目的

本研究旨在评估超声评估的膀胱颈活动过度与产后9 - 18个月初产妇使用UDI - 6问卷测量的压力性尿失禁发生之间的关系。

材料与方法

本研究纳入了100名首次分娩后9 - 18个月的女性,其中19%(研究组)存在尿道活动过度。使用超声确定膀胱颈的位置和活动度,以评估尿道活动过度。向量≥15 mm被定义为尿道活动过度。使用UDI - 6问卷的问题3评估压力性尿失禁症状,其中症状的存在被定义为评分为1至4的回答。

结果

我们证明尿道活动过度与压力性尿失禁症状之间存在统计学显著关系,统计学显著性水平<0.002。

结论

压力性尿失禁是女性常见疾病,其病理生理学尚未完全了解。它对生活质量、自我身体感知和性功能有不良影响。尿道固定受损可能在这种常见形式的尿失禁病理生理学中起重要作用。研究表明,超声评估的尿道活动过度与UDI - 6评分测量的压力性尿失禁有关。尽管压力性尿失禁是一种受解剖学变化和先天性解剖特征影响的多因素疾病,但它易于诊断。尿道下吊带是一种有效的手术技术;然而,术后排尿功能障碍或复发性压力性尿失禁的发生率为10 - 20%。因此,评估压力性尿失禁的解剖学变化可能有助于个体化手术策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a2e/10940277/8392a283d764/j_jou.2024.0010_fig_001.jpg

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