Bhatia N N, Bergman A, Gunning J E
Am J Obstet Gynecol. 1983 Dec 15;147(8):876-84. doi: 10.1016/0002-9378(83)90239-9.
The manner in which a vaginal pessary restores urinary continence is poorly understood. This report provides an explanation. Following placement of the vaginal pessary, detailed urodynamic studies in a group of 12 women with stress urinary incontinence demonstrated consistent and significant (p less than 0.005) increase in urethral functional length and urethral closure pressure under varying stressful conditions, when compared with prepessary studies. Postpessary stress testing also became normal (p less than 0.005). Prepessary and postpessary simultaneous voiding urethrocystometry and instrumented uroflowmetry demonstrated absence of obstruction to free flow of urine. Clinically, 10 of 12 patients became continent. Characteristic postpessary urodynamic alterations and Q-tip test changes provided an objective explanation that the vaginal pessary restored continence by stabilizing the urethra and urethrovesical junction to allow proper pressure transmission and by actively increasing urethral resistance to escape of urine under resting and stressful conditions.
阴道子宫托恢复尿失禁的方式目前还知之甚少。本报告对此做出了解释。在放置阴道子宫托后，对一组12名压力性尿失禁女性进行的详细尿动力学研究表明，与放置子宫托前的研究相比，在不同应激条件下，尿道功能长度和尿道闭合压持续且显著增加（p<0.005）。放置子宫托后的压力测试也恢复正常（p<0.005）。放置子宫托前后的同步排尿尿道膀胱测压和仪器化尿流率测定表明，尿液自由流动无梗阻。临床上，12名患者中有10名恢复了控尿能力。放置子宫托后的特征性尿动力学改变和棉签试验变化提供了一个客观的解释，即阴道子宫托通过稳定尿道和尿道膀胱连接处以允许适当的压力传递，并通过在静息和应激条件下积极增加尿道对尿液外溢的阻力来恢复控尿能力。
