van Venrooij G E, Boon T A
Department of Urology, University Hospital Utrecht, The Netherlands.
J Urol. 1994 Nov;152(5 Pt 1):1535-8. doi: 10.1016/s0022-5347(17)32464-3.
In 72 women with a clinical history of frequency and/or urge incontinence and in whom during filling cystometry nearly no abnormalities were detected, cystometry was repeated not by transurethral filling but under high diuretic conditions (diuresis cystometry). The prevalence and strength of detrusor instability, and the prevalence of incontinence were significantly greater during diuresis cystometry compared to filling cystometry. The experiences of these patients during episodes of instability were similar to those in their own daily environment. Most women with motor urge incontinence on filling or diuresis cystometry are losing urine at detrusor pressures lower than would be expected from urethral closure pressure measurements at rest. Therefore, urethral relaxation may have an important role in the etiology of incontinence. Apparent low amplitude detrusor instability may cause severe incontinence when combined with urethral relaxation. Extensive urodynamic investigations (including diuresis cystometry) will improve the clinical applicability of urodynamics.
在72名有尿频和/或急迫性尿失禁临床病史且在充盈性膀胱测压期间几乎未检测到异常的女性中，膀胱测压不是通过经尿道充盈进行重复，而是在高利尿条件下（利尿性膀胱测压）进行。与充盈性膀胱测压相比，利尿性膀胱测压期间逼尿肌不稳定的发生率和强度以及尿失禁的发生率显著更高。这些患者在不稳定发作期间的经历与他们日常环境中的经历相似。大多数在充盈或利尿性膀胱测压时有运动性急迫性尿失禁的女性在逼尿肌压力低于静息时尿道闭合压力测量预期值时就会漏尿。因此，尿道松弛可能在尿失禁的病因中起重要作用。明显的低幅度逼尿肌不稳定与尿道松弛相结合时可能导致严重尿失禁。广泛的尿动力学检查（包括利尿性膀胱测压）将提高尿动力学的临床适用性。
