Thüroff J W, Jonas U, Petri E, Frohneberg D
Prog Clin Biol Res. 1981;78:211-22.
The usual method of filling cystometry fails to assess the mechanism of urinary leakage in more than half the women who complain of incontinence. Telemetric studies with televised observation provide the patient with a relative degree of privacy and thus make possible urodynamic investigations independent of restrictive laboratory conditions. Twelve women (mean age 49.8 years) underwent usual cystometric studies and subsequent telemetric urodynamic study via identical catheters and electrodes. In regular cystometry urine loss was detected in four of 12 women, while telemetric study allowed evidence of urine loss in seven of 12 women. Leakage was provoked by raised bladder pressure under various simulated stress conditions. Five non-incontinent women in the telemetric study had markedly lower bladder pressures under stress conditions than the remainder of the patients. During the voiding phase, maximum and average flow rates were increased in the telemetric study despite a slightly reduced micturition pressure and a reduced volume voided. Our discussion shows this finding to be related to lowered psychogenic stress. The introduction of telemetric techniques in urodynamics provides a further refinement of investigative methods, which may help to better understand bladder and sphincter behavior both in normal physiologic conditions and in cases of pathologic changes.
常规的膀胱测压方法无法评估超过半数主诉尿失禁女性的尿液渗漏机制。采用电视观察的遥测研究为患者提供了一定程度的隐私,从而使尿动力学检查能够独立于受限的实验室条件进行。12名女性(平均年龄49.8岁)接受了常规膀胱测压研究,随后通过相同的导管和电极进行了遥测尿动力学研究。在常规膀胱测压中,12名女性中有4名检测到尿液丢失,而遥测研究显示12名女性中有7名有尿液丢失证据。在各种模拟应激条件下,膀胱压力升高会引发渗漏。遥测研究中的5名无尿失禁女性在应激条件下的膀胱压力明显低于其余患者。在排尿期,尽管排尿压力略有降低且排尿量减少,但遥测研究中的最大和平均流速增加。我们的讨论表明这一发现与心理性应激降低有关。尿动力学中遥测技术的引入进一步完善了检查方法,这可能有助于更好地理解正常生理状态以及病理变化情况下膀胱和括约肌的行为。