Theofrastous J P, Bump R C, Elser D M, Wyman J F, McClish D K
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, USA.
Am J Obstet Gynecol. 1995 Aug;173(2):407-12; discussion 412-4. doi: 10.1016/0002-9378(95)90260-0.
Our aim was to correlate multiple measures of urethral resistance with five clinical measures of incontinence severity in women with pure genuine stress incontinence.
Seventy-five women with pure genuine stress incontinence underwent passive and dynamic urethral pressure profilometry and Valsalva leak point pressure determinations. The standardized and validated measures of incontinence severity included (1) the number of incontinent episodes, (2) the number of continence pads used recorded in a prospective 1-week urinary dairy, (3) grams of fluid loss on a pad quantitation test, and (4) two condition-specific quality-of-life scales, the urogenital distress inventory and the incontinence impact questionnaire. The urodynamic and severity measures were compared with Pearson product-moment correlation analysis.
There were no significant correlations between dynamic urethral pressure profile pressure transmission ratios and any measure of incontinence severity. Passive urethral pressure profile variables correlated significantly with incontinence episodes and pad use. Valsalva leak point pressures correlated significantly with pad use and quantitation testing. None of the urodynamic measurements was significantly correlated with either of the quality-of-life scales, but our power to demonstrate a correlation was limited.
Both passive urethral pressure profile measures and Valsalva leak point pressures correlate with some severity measures of genuine stress incontinence. Although inefficient pressure transmission during stress is critical to the pathogenesis of genuine stress incontinence, the severity of the pressure transmission defect is not related to clinical severity. Conversely, impairment of intrinsic urethral resistance is not essential to the pathogenesis of genuine stress incontinence, but the degree of sphincteric impairment is related to severity once the condition exists.
我们的目的是将尿道阻力的多种测量指标与单纯性真性压力性尿失禁女性的五种尿失禁严重程度临床测量指标进行关联。
75名单纯性真性压力性尿失禁女性接受了被动和动态尿道压力测定以及瓦尔萨尔瓦漏尿点压力测定。尿失禁严重程度的标准化且经过验证的测量指标包括：（1）尿失禁发作次数；（2）在前瞻性1周尿日记中记录的使用尿垫数量；（3）尿垫定量试验中的失液克数；（4）两个特定病情的生活质量量表，即泌尿生殖系统困扰量表和尿失禁影响问卷。采用Pearson积差相关分析比较尿动力学指标和严重程度指标。
动态尿道压力测定的压力传递率与任何尿失禁严重程度测量指标之间均无显著相关性。被动尿道压力测定变量与尿失禁发作次数和尿垫使用显著相关。瓦尔萨尔瓦漏尿点压力与尿垫使用和定量试验显著相关。尿动力学测量指标与任何一个生活质量量表均无显著相关性，但我们证明相关性的能力有限。
被动尿道压力测定指标和瓦尔萨尔瓦漏尿点压力均与真性压力性尿失禁的某些严重程度指标相关。虽然压力状态下无效的压力传递对真性压力性尿失禁的发病机制至关重要，但压力传递缺陷的严重程度与临床严重程度无关。相反，固有尿道阻力受损对真性压力性尿失禁的发病机制并非必不可少，但一旦出现这种情况，括约肌受损程度与严重程度相关。
