超声在女性压力性尿失禁诊治中的应用价值

Ultrasound study in the diagnosis and treatment of the female stress urinary incontinence

目的 探讨超声参数在评估女性压力性尿失禁（SUI）中的作用及意义.方法 应用超声测量46例女性SUI患者（研究组）行经闭孔无张力悬吊带术（TVT-O）前后膀胱颈活动度、膀胱尿道后角、尿道角及残余尿量的变化,并与43例体检正常妇女（对照组）进行比较.结果 研究组术前膀胱颈活动度及膀胱尿道后角[（14.46±1.28）mm、（124.87±2.95）°]大于对照组[（7.47±0.55）mm、（107.83±3.24）°]（P＜0.01）,尿道角[（23.61±2.28）°]小于对照组[（36.24±2.23）°]（P＜0.01）;研究组术后各参数与对照组比较,差异均无统计学意义（P＞0.05）.研究组术后膀胱颈活动度及膀胱尿道后角[（7.84±0.76）mm、（108.74±3.63）.]小于术前（P＜0.01）,尿道角[（34.39±3.46）.]大于术前（P＜0.01）,而残余尿量组内、组间比较差异均无统计学意义（P＞0.05）.结论 女性SUI患者经手术治疗后膀胱颈活动度、膀胱尿道后角、尿道角都有不同程度的改变,可以基本恢复到正常状态,且疗效相对稳定;手术不增加患者的残余尿量;超声在排除精神心理因素之后,对客观评估病情轻重和治疗后的恢复状态有着其他检查手段不可代替的优势.

Objective To evaluate the significance and role of ultrasound parameters in the female stress urinary incontinence （SUI）. Methods The changes of the distance of bladder neck mobility,posterior urethra-vesical angle,urethral angle and residual urine volume before and after the operation of transobturator tension-free vaginal tape surgery （TVT-O） for 46 cases of female SUI （experimental group ） by ultrasound were studied,and compared with 43 normal women （control group）. Results The experimental group before the operation had the greater distance of bladder neck mobility and posterior urethra-vesical angle [（14.46 ± 1.28） mm, （124.87 ±2.95）°] than the control group [（7.47 ±0.55） mm, （107.83 ±3.24）°] （P 〈 0.01 ）, but the urethral angle [（ 23.61 ± 2.28 ）°] was smaller than the control group [（36.24 ±2.23 ）°] （P 〈 0.01 ）. There was no significant difference in the distance of bladder neck mobility, posterior urethra-vesical angle, urethral angle and residual urine volume between the experimental group after the operation and the control group （P 〉 0.05 ）. The experimental group before the operation had the greater distance of bladder neck mobility and posterior urethra-vesieal angle than those after the operation [（7.84±0.76） mm, （108.74±3.63）°] （P 〈0.01）, the urethral angle was smaller than that after the operation [（34.39 ± 3.46）°] （P 〈 0.01 ）, but the residual urine volume had no significant difference （P 〉 0.05 ）.Conclusions After the operation, there are some changes in the distance of bladder neck mobility, posterior urethra-vesical angle and urethral angle for the patients with female SUI,and these parameters can be restored the normal state,and have the relatively stable effect. The residual urine volume dosen＇t increase after the operation. Ultrasound has the advantage in objectively assessing the severity and recovery status after the operation exclusion of mental and psychological factors.