Elia G, Bergman A
Department of Obstetrics and Gynecology, Women's Hospital, University of Southern California School of Medicine, Los Angeles.
Obstet Gynecol. 1993 Feb;81(2):283-6.
To identify urodynamic indices that can predict the outcome of pelvic muscle exercises in women with genuine stress urinary incontinence.
Thirty-six women with genuine stress urinary incontinence were evaluated during a 6-month period. Urodynamic studies were performed before and 3 months after completion of a program of Kegel pelvic muscle exercises. Subjective symptoms and objective loss of urine as well as pad count were used to evaluate the outcome of the exercise program. A receiver-operating characteristic curve was used to assess the prognostic value of the pressure transmission ratio between the abdomen and urethra.
Twenty patients (56%) were cured or substantially improved 3 months after completing the pelvic muscle training, whereas 16 were unchanged. The urethral closure pressure significantly increased in the subjects cured or improved. After successful training, significant changes were noted in the pressure transmission ratio between the abdomen and urethra on cough. Six of seven subjects with mild incontinence responded favorably, whereas 13 of 15 with severe incontinence did not improve after the training. The pressure transmission ratio plotted on a receiver-operating characteristic curve was found to have optimal predictive value at the 80% level.
Kegel pelvic muscle exercises give a better outcome in women with mild stress urinary incontinence and/or with a pressure transmission ratio between the abdomen and urethra of 80% or more.
确定能预测真性压力性尿失禁女性盆底肌锻炼效果的尿动力学指标。
在6个月期间对36名真性压力性尿失禁女性进行评估。在进行凯格尔盆底肌锻炼计划之前及完成后3个月进行尿动力学研究。采用主观症状、客观漏尿情况以及护垫使用量来评估锻炼计划的效果。使用受试者操作特征曲线评估腹部与尿道之间压力传递率的预后价值。
20名患者（56%）在完成盆底肌训练3个月后治愈或显著改善，而16名患者无变化。治愈或改善的受试者尿道闭合压显著升高。成功训练后，咳嗽时腹部与尿道之间的压力传递率出现显著变化。7名轻度尿失禁受试者中有6名反应良好，而15名重度尿失禁受试者中有13名训练后未改善。绘制在受试者操作特征曲线上的压力传递率在80%水平时具有最佳预测价值。
凯格尔盆底肌锻炼对轻度压力性尿失禁和/或腹部与尿道之间压力传递率达80%或更高的女性效果更佳。
