超声评价女性压力性尿失禁患者尿道不同分段的移动度

Ultrasound observation of sublevel urethral mobility in females with stress urinary incontinence

目的评价超声观察尿道不同分段的移动度对于诊断女性压力性尿失禁(SUI)的价值。方法分别在静息状态和Valsalva最大位移时对45例SUI患者(病例组)和20名正常受试(对照组)进行经会阴超声扫查。将整段尿道分为6段,并以耻骨联合为参照建立直角坐标系,测量尿道各个分段在两种状态下的坐标值,计算各分段的移动度。结果与对照组比较,病例组尿道不同分段移动度存在不同差异。病例组代表尿道中段的U-2,3,4三点的移动度分别为(2.63±0.62)、(2.32±0.47)、(2.01±0.41)cm,对照组分别为(2.21±0.54)、(1.92±0.42)、(1.69±0.36)cm,差异有统计学意义(P<0.05);病例组U-1,5,6三点移动度分别为(3.01±0.76)、(1.85±0.37)、(1.86±0.66)cm,对照组分别为(2.69±0.87)、(1.72±0.40)、(1.74±0.45)cm,两组差异无统计学意义(P>0.05)。结论女性SUI与尿道移动度增加、特别是中段尿道移动度的增加有关;经会阴超声能够清晰再现盆底结构,观察尿道不同分段的移动度,有利于诊断SUI。

Objective To explore the value of ultrasound in observation on segmentation urethra mobility in females of stress urinary incontinence（SUI）.Methods Perineum ultrasonography was performed on 45 females with SUI（SUI group） and 20 normal controls（control group） under quiescent condition and Valsalva maximum deflection.The urethra was segmented into 6 stages,and rectangular coordinates was set up in accordance with pubic symphysis.Each stage’s coordinate was recorded,and the mobility was calculated.Results There were differenced in segmentation urethra mobility between SUI group and control SUI.The mobility measured at U-2,3,4 point which represented middle segment of urethra was（2.63±0.62）,（2.32±0.47）,and（2.01±0.41）cm in SUI group,respectively,while（2.21±0.54）,（1.92±0.42）,and（1.69±0.36） cm in control group,respectively（all P〈0.05）.The mobility measured at U-1,5,6 point which represented middle segment of urethra was（3.01±0.76）,（1.85±0.37）,and（1.86±0.66）cm in SUI group,respectively,while（2.69±0.87）,（1.72±0.40）,and（1.74±0.45）cm in control group,respectively（all P〉0.05）.Conclusion Urethra mobility,especially middle segment of urethra,correlates with SUI in females.Perineum ultrasonography can clearly display pelvic bottom structures.Observation on segmentation urethra mobility with ultrasound helps to diagnosis of SUI in females.