Feng Yankun, He Guibing, Fu Shihan, Hu Yangzhi, Wang Qiben, Zhai Lidong, Yu Rui
Department of Human Anatomy, School of Basic Medical Sciences, Xiangnan University, Chenzhou, China.
Department of Urology, Jinhua People's Hospital, Jinhua, China.
Transl Androl Urol. 2025 Apr 30;14(4):1036-1048. doi: 10.21037/tau-2024-695. Epub 2025 Apr 27.
The position and lines of the compressor urethrae, as well as the different segments and morphological characteristics of the compressor urethrae and urethra have not been systematically characterized. This study thus aimed to quantify the lines, thickness, volume, surface area, and position of the compressor urethrae, as well as the thickness, volume, and surface area in the upper, middle, and lower urethra, in postpartum females via three-dimensional (3D) measurement and analysis methods.
This retrospective study included a total of 90 postpartum women. The 3D models of compressor urethrae and urethra were constructed based on the imaging pictures of these women. The indicators that were analyzed in a 3D plane included volume, surface area, thickness, and diameter lines of the compressor urethrae; the ratio of the compressor urethrae length (CUL) to the urethral length (UL); the distance between the compressor urethrae and the pubic symphysis; the volume, surface area, and thickness of urethra and its different segments; the UL; and the urethral inclination angle (UIA). These indicators were compared between a postpartum-stress urinary incontinence (SUI) group and a control group. Differences in indicators between the segments of urethra were compared. The relationship between related indicators of the compressor urethrae and of the urethra with age was determined.
The length, width, and volume of the compressor urethrae in the control group were 23.24±3.29 mm, 24.61±3.79 mm, and 1.47±0.49 cm, respectively. The upper, middle and lower regions of the urethral volume in the control group were 2.58±0.59, 2.10±0.32, and 0.84±0.37 cm, respectively. The volume and thickness of the compressor urethrae, the CUL, and volume of the upper and middle regions of the urethra in the control group were significantly larger than those in the SUI group (P=0.002, P=0.02, P=0.01, P=0.003, and P<0.001, respectively). The volume and surface area of middle urethra were significantly larger than those of the lower urethra (P<0.001 and P<0.001, respectively). The compressor urethrae volume (r=-0.506; P=0.004), compressor urethrae surface area (r=-0.523; P=0.003), middle urethral volume (r=-0.403; P=0.03), and middle urethral thickness (r=-0.629; P<0.001) were negatively correlated with age.
This study provides reference criteria for the volume, thickness, and surface area of different portions of the compressor urethrae and urethra. The upper and middle urethra may be particularly significant to female urinary continence. Meanwhile, strengthening of the compressor urethrae might help treat female urinary continence.
尿道压缩肌的位置和走行，以及尿道压缩肌和尿道不同节段的形态特征尚未得到系统描述。因此，本研究旨在通过三维（3D）测量和分析方法，量化产后女性尿道压缩肌的走行、厚度、体积、表面积和位置，以及尿道上、中、下节段的厚度、体积和表面积。
本回顾性研究共纳入90名产后女性。基于这些女性的影像学图片构建尿道压缩肌和尿道的3D模型。在3D平面上分析的指标包括尿道压缩肌的体积、表面积、厚度和直径线；尿道压缩肌长度（CUL）与尿道长度（UL）的比值；尿道压缩肌与耻骨联合之间的距离；尿道及其不同节段的体积、表面积和厚度；UL；以及尿道倾斜角（UIA）。比较产后压力性尿失禁（SUI）组和对照组之间的这些指标。比较尿道各节段之间指标的差异。确定尿道压缩肌和尿道相关指标与年龄之间的关系。
对照组尿道压缩肌的长度、宽度和体积分别为23.24±3.29mm、24.61±3.79mm和1.47±0.49cm³。对照组尿道上、中、下节段的体积分别为2.58±0.59cm³、2.10±0.32cm³和0.84±0.37cm³。对照组尿道压缩肌的体积和厚度、CUL以及尿道上、中节段的体积均显著大于SUI组（分别为P=0.002、P=0.02、P=0.01、P=0.003和P<0.001）。尿道中段的体积和表面积显著大于下段（分别为P<0.001和P<0.001）。尿道压缩肌体积（r=-0.506；P=0.004）、尿道压缩肌表面积（r=-0.523；P=0.003）、尿道中段体积（r=-0.403；P=0.03）和尿道中段厚度（r=-0.629；P<0.001）与年龄呈负相关。
本研究为尿道压缩肌和尿道不同部位的体积、厚度和表面积提供了参考标准。尿道上、中段对女性尿失禁可能尤为重要。同时，加强尿道压缩肌可能有助于治疗女性尿失禁。
