Kirschner-Hermanns R, Klein H M, Müller U, Schäfer W, Jakse G
Department of Urology, University Hospital, RWTH Aachen, Germany.
Br J Urol. 1994 Sep;74(3):315-8. doi: 10.1111/j.1464-410x.1994.tb16618.x.
To investigate whether the sphincter area in women can be seen and quantified with intra-urethral ultrasound (IUUS). Currently, sphincter capacity in women is determined by clinical tests, vaginal palpation, urodynamics and urethral pressure profile.
A pilot study using IUUS was carried out in 32 stress incontinent and 12 healthy women to enable the urethra and para-urethral tissue to be visualized. Round-tipped miniature transducer-containing (20 MHz) catheters (6 and 9 F) were tested. Both provided 15 frames per second. Real-time 360 degrees cross-sectional ultrasound images were obtained by using a standard intraluminal ultrasound system. The external urethral sphincter was visualized and its circumference and area were measured.
IUUS provided high resolution imaging of the urethra and surrounding tissues. The whole length of the urethra was visualized. The external sphincter was easily recognized as an oval-shaped, hypoechoic structure. Examination of 44 stress incontinent and healthy women revealed a negative correlation between the external urethral sphincter (area and circumference) and the grade of stress incontinence (P < 0.01). In no patient with normal urinary continence was the sphincter reduced in size (< 2.8 cm circumference).
IUUS is a useful technique in the diagnosis of incontinence, as conventional methods provide little information on the sphincter itself. The evaluation of sphincter size and morphology could help in the choice of therapy.
探讨经尿道超声检查（IUUS）能否观察并量化女性尿道括约肌区域。目前，女性括约肌功能通过临床检查、阴道触诊、尿动力学检查及尿道压力描记来确定。
对32例压力性尿失禁女性患者和12例健康女性进行了一项使用IUUS的初步研究，以观察尿道及尿道旁组织。测试了含圆形尖端微型换能器（20MHz）的导管（6F和9F）。两者均能提供每秒15帧图像。使用标准腔内超声系统获取实时360度横截面超声图像。观察尿道外括约肌并测量其周长和面积。
IUUS能提供尿道及周围组织的高分辨率图像。可观察到尿道全长。外括约肌易于识别为椭圆形低回声结构。对44例压力性尿失禁女性患者和健康女性的检查显示，尿道外括约肌（面积和周长）与压力性尿失禁分级呈负相关（P<0.01）。无尿失禁的患者中，括约肌大小均未减小（周长<2.8cm）。
IUUS是诊断尿失禁的一种有用技术，因为传统方法对括约肌本身提供的信息很少。评估括约肌大小和形态有助于治疗方案的选择。
