Department of Radiology, Beijing Chao Yang Hospital, Capital Medical University, 8 Workers Stadium South Road, Chaoyang District, Beijing, 10020, China.
Department of Urology, Beijing Chao Yang Hospital, Capital Medical University, 8 Workers Stadium South Road, Chaoyang District, Beijing, 10020, China.
World J Urol. 2024 May 14;42(1):321. doi: 10.1007/s00345-024-05014-0.
Utilize magnetic resonance defecography (MRD) to analyze the primary pelvic floor dysfunctions in patients with stress urinary incontinence (SUI) associated with pelvic organ prolapse (POP), and in SUI patients with asymptomatic POP.
We performed MRD in both SUI and POP subjects. As a primary analysis, the functional MR parameters were compared between the isolated POP and POP combined SUI groups. As a secondary analysis, the functional MR data were compared between the POP combined SUI and the SUI with asymptomatic POP (isolated SUI) groups.
MRD noted the main characteristics of SUI combined moderate or severe POP, including the shorter closed urethra length (1.87 cm vs. 2.50 cm, p < 0.001), more prevalent urethral hypermobility (112.31° vs. 85.67°, p = 0.003), bladder neck funneling (48.28% vs. 20.51%, p = 0.020), lower position of vesicourethral junction (2.11 cm vs. 1.67 cm, p = 0.030), and more severe prolapse of the posterior bladder wall (6.26 cm vs. 4.35 cm, p = 0.008). The isolated SUI patients showed the shortest length of the closed urethra (1.56 cm vs. 1.87 cm, p = 0.029), a larger vesicourethral angle (153.80° vs. 107.58°, p < 0.001), the more positive bladder funneling (84.85% vs. 48.28%, p = 0.002) and a special urethral opening sign (45.45% vs. 3.45%, p < 0.001).
Patients with SUI accompanying POP primarily exhibit excessive urethral mobility and a shortened urethral closure. SUI patients with asymptomatic POP mainly show dysfunction of the urethra and bladder neck, characterized by the opening of the urethra and bladder neck and a shortened urethral closure.
利用磁共振排粪造影（MRD）分析压力性尿失禁（SUI）伴盆腔器官脱垂（POP）患者和无症状 POP 的 SUI 患者的主要盆底功能障碍。
对 SUI 和 POP 患者进行 MRD 检查。作为主要分析，比较单纯 POP 组和 POP 合并 SUI 组的功能 MR 参数。作为次要分析，比较 POP 合并 SUI 组和单纯 SUI 伴无症状 POP（单纯 SUI）组的功能 MR 数据。
MRD 显示 SUI 合并中重度 POP 的主要特征，包括较短的闭合尿道长度（1.87cm 比 2.50cm，p<0.001）、更普遍的尿道过度活动（112.31°比 85.67°，p=0.003）、膀胱颈漏斗形成（48.28%比 20.51%，p=0.020）、较低的膀胱颈-尿道连接位置（2.11cm 比 1.67cm，p=0.030）和更严重的后膀胱壁脱垂（6.26cm 比 4.35cm，p=0.008）。单纯 SUI 患者的闭合尿道长度最短（1.56cm 比 1.87cm，p=0.029），膀胱颈-尿道角较大（153.80°比 107.58°，p<0.001），膀胱漏斗形成更阳性（84.85%比 48.28%，p=0.002）和特殊的尿道开口征（45.45%比 3.45%，p<0.001）。
SUI 伴 POP 的患者主要表现为尿道过度活动和尿道闭合缩短。无症状 POP 的 SUI 患者主要表现为尿道和膀胱颈功能障碍，表现为尿道和膀胱颈开口以及尿道闭合缩短。
