Meyer S, de Grandi P, Caccia G, Gerber S
Gyn.-Obst Department, CHUV, Lausanne, Switzerland.
Neurourol Urodyn. 1997;16(4):277-84. doi: 10.1002/(sici)1520-6777(1997)16:4<277::aid-nau3>3.0.co;2-b.
Our objective was to investigate any correlation between the degree of urethro-vesical junction (UVJ) mobility and the pressure transmission ratio (PTR) values. Five hundred and nineteen patients suffering from stress urinary incontinence were divided into four groups according to their degree of UVJ mobility assessed by the Q-tip test method: group 1 (N = 86), urethral axis at stress (UAS) < 30 degrees; group 2 (N = 191), UAS 31-60 degrees; group 3 (N = 214), UAS 61-90 degrees; and group 4 (N = 28), UAS > 90 degrees. A urethral pressure profile at stress was determined in the supine and standing positions, and PTR was calculated in the middle region of urethral functional length. PTR values for groups 2-4 were compared with those for group 1. In the supine position, the values for groups 3 and 4 were lower than for group 1, while in the standing position, only the values for group 3 were different. The incidence of normal PTR values (i.e., > 90%) was the same in all four groups. Overall correlation between PTR values and degree of UVJ mobility was weak (r = 0.14). We conclude that PTR values does not correlate with UVJ mobility in those patients with a Q-tip test of < 60 degrees. This correlation is inconstant when the Q-tip test was > 60 degrees. Also, 14-30% of patients in all four groups had normal standing PTR values. This may be explained by well-preserved innervation with severe alteration of the anchoring bladder neck structures.
我们的目的是研究尿道膀胱连接部（UVJ）活动度与压力传递率（PTR）值之间的相关性。519例压力性尿失禁患者根据Q-tip试验法评估的UVJ活动度分为四组：第1组（N = 86），应力下尿道轴（UAS）<30度；第2组（N = 191），UAS 31 - 60度；第3组（N = 214），UAS 61 - 90度；第4组（N = 28），UAS>90度。在仰卧位和站立位测定应力下尿道压力分布图，并在尿道功能长度的中间区域计算PTR。将第2 - 4组的PTR值与第1组进行比较。在仰卧位时，第3组和第4组的值低于第1组，而在站立位时，只有第3组的值不同。所有四组中正常PTR值（即>90%）的发生率相同。PTR值与UVJ活动度之间的总体相关性较弱（r = 0.14）。我们得出结论，在Q-tip试验<60度的患者中，PTR值与UVJ活动度不相关。当Q-tip试验>60度时，这种相关性不稳定。此外，所有四组中14 - 30%的患者站立位PTR值正常。这可能是由于神经支配保存良好但膀胱颈锚定结构严重改变所致。
