Peacock L M, Wiskind A K, Wall L L
Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA 30303.
Am J Obstet Gynecol. 1994 Dec;171(6):1464-9; discussion 1469-71. doi: 10.1016/0002-9378(94)90389-1.
Our purpose was to describe the clinical features and urodynamic findings of a black female inner-city population with urinary incontinence and uterovaginal prolapse.
A retrospective review of the urogynecoloy records of 159 black female patients was performed.
Genital prolapse was common. A cystocele was identified in 116 patients, a rectocele in 88 patients, and uterine or vaginal vault prolapse in 41 patients. Subtracted multichannel cystometry revealed detrusor overactivity in 58 patients, genuine stress incontinence in 44 patients, and mixed incontinence in 30 patients. Sixteen patients had normal urodynamic studies. The presence of a cystocele and the physical sign of stress incontinence at initial examination were found equally in patients with genuine stress incontinence, detrusor instability, and mixed incontinence at cystometry. There was no correlation between other commonly associated clinical factors (such as age, parity, and obesity) and the urodynamic diagnosis.
Many of the factors commonly assumed to predispose women to the development of incontinence and prolapse may not apply to the black inner-city population. Urodynamic testing to establish the correct diagnosis is required, because the correlation between symptoms, physical examination, and urodynamic findings is relatively poor in this population.
我们的目的是描述患有尿失禁和子宫阴道脱垂的黑人女性城市内人群的临床特征及尿动力学检查结果。
对159例黑人女性患者的泌尿妇科记录进行回顾性分析。
生殖器脱垂很常见。116例患者发现膀胱膨出，88例患者发现直肠膨出，41例患者发现子宫或阴道穹窿脱垂。多通道膀胱测压检查显示58例患者存在逼尿肌过度活动，44例患者存在真性压力性尿失禁，30例患者存在混合性尿失禁。16例患者尿动力学检查正常。膀胱测压检查发现真性压力性尿失禁、逼尿肌不稳定和混合性尿失禁的患者，在初次检查时膀胱膨出的存在情况及压力性尿失禁的体征相当。其他常见相关临床因素（如年龄、产次和肥胖）与尿动力学诊断之间无相关性。
许多通常被认为易使女性发生尿失禁和脱垂的因素可能不适用于城市内黑人人群。由于该人群中症状、体格检查和尿动力学检查结果之间的相关性相对较差，因此需要进行尿动力学检查以明确正确诊断。
