Masuda H, Yamada T, Nagamatsu H, Nagahama K, Kawakami S, Watanabe T, Negishi T
Department of Urology, Kasukabe Municipal Hospital.
Nihon Hinyokika Gakkai Zasshi. 1994 Mar;85(3):434-9. doi: 10.5980/jpnjurol1989.85.434.
The urethral pressure profiles (UPP) at rest and under stress, using double lumens microtip transducer catheter, in 17 females without urinary incontinence (normal group) were compared with those in 39 females with stress urinary incontinence (SUI group). And UPP were compared pre- and postoperatively in 21 females of SUI group who had surgical cure of SUI by bladder neck suspension (operative group). Pressure transmission ratios (PTR) were calculated in each quartile dividing functional urethral length (FUL) into four equal lengths. Maximum urethral closure pressure (MUCP) and Functional urethral length (FUL) in normal group were significantly higher than those in SUI group. In normal group, although bladder neck opening under stress (bladder neck incompetence) existed in 41% of them, the PTR in the distal three-quarters of the FUL were significantly larger than those in SUI group and urinary continence was remained in all of them. On the contrary, in SUI group, there was an almost linear decrease in the value of the PTR along the FUL. Therefore, it was suggested that SUI patients might lose distal urethral compensatory mechanisms. The results, obtained from the resting UPP, show that there is no significant change in MUCP or FUL following bladder neck suspension. In contrast, the stress UPP shows that successful operation generated a magnification of the PTR in the proximal three-quarters of the FUL. Only 1 case of post operative group showed bladder neck incompetence. Therefore suspending the bladder neck in a high position might produce the ability to occlude proximal three-quarters of the FUL.
使用双腔微尖端换能器导管，对17名无尿失禁的女性（正常组）静息和应激状态下的尿道压力分布（UPP）与39名压力性尿失禁女性（SUI组）进行了比较。并对21名通过膀胱颈悬吊术手术治愈SUI的SUI组女性（手术组）术前和术后的UPP进行了比较。在将功能性尿道长度（FUL）等分为四段的每个四分位数中计算压力传递率（PTR）。正常组的最大尿道闭合压（MUCP）和功能性尿道长度（FUL）显著高于SUI组。在正常组中，尽管41%的人存在应激状态下膀胱颈开放（膀胱颈功能不全），但FUL远端四分之三的PTR显著大于SUI组，且她们均保持尿失禁。相反，在SUI组中，PTR值沿FUL几乎呈线性下降。因此，提示SUI患者可能失去了远端尿道的代偿机制。静息UPP的结果显示，膀胱颈悬吊术后MUCP或FUL无显著变化。相比之下，应激UPP显示，成功的手术使FUL近端四分之三的PTR增大。手术组仅1例出现膀胱颈功能不全。因此，高位悬吊膀胱颈可能产生闭合FUL近端四分之三的能力。
