超声评价女性压力性尿失禁

Study of female stress urinary incontinence by ultrasonography

目的 探讨超声测量参数在女性压力性尿失禁(SUI)评价中的价值。方法 对31例SUI女性患者进行尿道外口超声检查。以耻骨联合下端为原点,沿耻骨联合线45°夹角分别建立X Y坐标轴。于安静状态和深吸气时,测量膀胱颈与耻骨下端的距离以及膀胱颈所对应的坐标值,分别为Dr、Xr、Yr和Ds、Xs、Ys。运用三角函数计算出两种状态下的膀胱颈角度θr、θs、旋转角度Δθ(θs-θr),以及深吸气时膀胱颈移动的距离M。结果 SUI患者深吸气时Y值增大,ΔY(Ys-Yr)明显高于ΔX。ΔY、Δθ、距离M随遗尿量增大而增加。结论 膀胱颈向下移动的距离ΔY、旋转角度Δθ、移动距离M与SUI的严重程度有相关性,能反映膀胱颈的活动度,对SUI的诊断有帮助。

Objective To assess the effectiveness of ultrasonographic parameters for evaluating female stress urinary incontinence(SUI). Methods Introital ultrasonography using a transvaginal probe was performed to evaluate the mobility of the bladder neck in 31 female patients with SUI. The bladder neck position was plotted on an assumed X Y coordinate system with the tip of symphysis pubis as origin and symphyseal mid line intersected the X and Y axis at an angle of 45°. Distances from the bladder neck to the lower tip of symphysis pubis and the corresponding X and Y values were measured at rest and during stress. Angles between the symphyseal mid line and the line of the lower tip of symphysis pubis and the bladder neck were calculated at rest(θr) and during stress(θs) separately. The bladder neck mobility was calculated by triangle function. Results Compared to the values at rest, Y values increased significantly during stress. The differences between the Y stress and Y rest(ΔY) was significantly higher than ΔX. With the increase of the amount of 1 hour standardized pad test, ΔY, the rotational angle(Δθ) of the bladder neck from θs to θr and the bladder neck mobility went up significantly. Conclusions The ΔY values on the X Y coordinate system, the rotational angle (Δθ) and the bladder neck mobility had correlation with the severity of SUI and could effectively evaluate the mobility of bladder neck. These parameters were helpful in the diagnosis of SUI.