Chen G D, Lin L Y, Gardner J D, Yeh N H, Wu G S
Department of Obstetrics and Gynecology, Chung Shan Medical and Dental College Hospital, Taiwan, Republic of China.
J Urol. 1998 Mar;159(3):754-7.
With the patient standing and supine we determine the differences in dynamic changes of the bladder neck and directions of dynamic bladder neck displacement.
To evaluate the dynamic movement of the bladder neck we recruited into the study 78 consecutive women 27 to 69 years old with various urogynecological complaints. The anatomical changes of the bladder neck from rest to maximal straining and from rest to holding were evaluated and compared with the patients supine and standing.
Except for bladder neck rotational angle with the patient standing, all parameters were significantly different from corresponding measurements with the patient supine. Mean rotational angle of rest to maximal straining plus or minus standard deviation was 39.4 +/- 18.9 degrees when standing versus 39.8 +/- 23.4 degrees when supine (p > 0.05). The distances between the bladder neck and symphysis pubis at rest, and during maximal straining and holding the bladder neck in the supine position were significantly longer than those in the standing position. The direction of bladder neck displacement from rest to maximal straining was more caudad and ventral when standing. The bladder neck moved cephalad and ventral when the patient was standing, and cephalad and dorsal with the patient supine and holding the bladder neck.
The anatomical locations and dynamic displacements of the bladder neck at rest, and during maximal straining and holding were significantly different in the supine and standing positions. While evaluating the dynamic motion of the bladder neck to determine bladder neck mobility, patient position must be considered and specified in accordance with diagnostic standards.
让患者站立和仰卧，我们确定膀胱颈动态变化的差异以及膀胱颈动态移位的方向。
为评估膀胱颈的动态运动，我们招募了78名年龄在27至69岁之间、患有各种泌尿妇科疾病的连续女性参与研究。评估了膀胱颈从静息状态到最大用力状态以及从静息状态到憋尿状态的解剖学变化，并将患者仰卧位和站立位的情况进行了比较。
除患者站立时的膀胱颈旋转角度外，所有参数与患者仰卧位时的相应测量值均有显著差异。站立时静息状态到最大用力状态的平均旋转角度加减标准差为39.4±18.9度，而仰卧位时为39.8±23.4度（p>0.05）。仰卧位时静息状态下、最大用力状态下以及憋尿时膀胱颈与耻骨联合之间的距离明显长于站立位时。站立时从静息状态到最大用力状态膀胱颈移位的方向更偏向尾侧和腹侧。患者站立时膀胱颈向头侧和腹侧移动，而患者仰卧位憋尿时膀胱颈向头侧和背侧移动。
仰卧位和站立位时，静息状态下以及最大用力状态和憋尿时膀胱颈的解剖位置和动态移位有显著差异。在评估膀胱颈的动态运动以确定膀胱颈活动度时，必须根据诊断标准考虑并明确患者的体位。
