Richardson D A, Bent A E, Ostergard D R
Am J Obstet Gynecol. 1983 Aug 15;146(8):901-5. doi: 10.1016/0002-9378(83)90961-4.
Complete urodynamic evaluations were performed on patients with severe uterovaginal prolapse with the prolapse protruding and after reduction with a pessary. These results were compared with those from patients with genuine stress incontinence without prolapse. There was a significant increase in urethral closure pressure in patients with prolapse on the assumption of a more erect posture or on Valsalva maneuver. The opposite relationship was observed in patients with genuine stress incontinence in whom the urethral closure pressure significantly decreased under similar conditions. These results strongly suggest that the mechanism of continence in patients with significant prolapse is urethral obstruction. Reduction of the prolapse with a pessary can differentiate those patients who will require urethrovesical neck suspension.
对重度子宫阴道脱垂且脱垂物突出的患者以及使用子宫托复位后的患者进行了全面的尿动力学评估。将这些结果与无脱垂的真性压力性尿失禁患者的结果进行比较。在脱垂患者中，假设姿势更直立或进行瓦尔萨尔瓦动作时，尿道闭合压显著升高。在真性压力性尿失禁患者中观察到相反的关系，即在类似情况下尿道闭合压显著降低。这些结果有力地表明，严重脱垂患者的控尿机制是尿道梗阻。使用子宫托复位脱垂可区分出那些需要进行尿道膀胱颈悬吊术的患者。
