Schmidt R A, Tanagho E A
Urology. 1981 Oct;18(4):424-7. doi: 10.1016/0090-4295(81)90410-6.
Urodynamic studies of 25 women between eleven and forty-five years of age whose history included frequent urinary tract infections disclosed urethral activity different from that of women with pure stress incontinence. Often the former had associated symptoms of urge, although the latter did not. Not all symptoms of infections were documented by culture, hence could have been related to tension in the pelvic floor rather than to bacteriuria. Urodynamic studies showed spasticity of the urethral musculature. The women with frequent urinary tract infections uniformly had hyperactive urethral striated muscle, those with the most severe form of urge showing varying resting tension in the urethral sphincter. In all cases, discomfort or urge was proportional to the elevation in urethral sphincter pressure and dramatically diminished with drop in closure tonus. In many cases relief of urge occurred only with voiding-when relaxation of the pelvic floor musculature could be induced by the patient. Urethral symptoms result from physiologic imbalance in urethral activity and may predispose to urinary tract infection. Thus, physicians treating urge complaints in young women should be aware that both entities have to be treated.
对25名年龄在11岁至45岁之间、有频繁尿路感染病史的女性进行尿动力学研究发现，她们的尿道活动与单纯压力性尿失禁女性不同。前者常常伴有尿急症状，而后者则没有。并非所有感染症状都通过培养记录下来，因此可能与盆底张力有关，而非与菌尿有关。尿动力学研究显示尿道肌肉组织痉挛。频繁尿路感染的女性均有尿道横纹肌活动亢进，最严重尿急形式的女性尿道括约肌静息张力各不相同。在所有病例中，不适或尿急与尿道括约肌压力升高成正比，随着关闭张力下降而显著减轻。在许多病例中，只有排尿时尿急才会缓解——此时患者可诱导盆底肌肉组织放松。尿道症状源于尿道活动的生理失衡，可能易引发尿路感染。因此，治疗年轻女性尿急症状的医生应意识到这两种情况都需要治疗。
