女性尿道中静态尿道压力分布特点的研究

The features of pressure distribution of rest urethral pressure profile in female urethra

目的:探讨在女性尿道不同部位和不同方向上静态尿道压力图(RUPP)压力的分布特点。方法:本研究共包括因各种原因需做尿动力学检查的成年女性患者55例,年龄(41±11)岁,其中尿流动力学检查无异常者8例,压力性尿失禁19例,其他诊断(包括OAB、膀胱收缩无力等)28例。采用恒压恒速灌注法测压,将测压孔分别朝向尿道前壁(12点)、后壁(6点)、左侧壁(3点)及右侧壁(9点)四个方向描记RUPP,采用配伍区组方差分析进行统计学分析。结果:前壁的最大尿道闭合压(MUCP)最高(P<0.01),后壁的MUCP最低(P<0.001),左右两侧MUCP无明显差异(P=0.571);前壁的功能尿道长度(FUL)最短(P<0.01),后壁的FUL最长(P<0.001),左右两侧FUL无统计学差异(P=0.717);RUPP曲线均呈抛物线形,高压区和MUCP的最大值位于尿道中段或中远段交界处。结论:本研究结果显示,静态尿道压力图在女性尿道压力分布上,前后壁方向上具有显著的方向性变异,而左右两侧具有对称性和一致性。尿道压力图的压力分布特点与女性尿道壁的组织结构和尿道腔的形态密切相关。

Objective：To investigate the features of pressure distribution of rest urethral pressure profile in the female urethra. Methods：Totally 55 adult females referred for urodynamic evaluation of lower urinary tract symp- toms were included in this study, mean age（41±11）yrs. Rest urethral pressure profile（RUPP） were recorded in four different positions in the urethra （anterior/12 o＇clock, posterior/6 o＇clock, left/3 o＇clock and right/9 o＇clock）. The Wilcoxon matched pairs signed rank test was used to compare the data of the RUPP in different catheter orientations with SPSS software （16.0）. Results： The maximum urethral closure pressure （MUCP） is always highest in the anterior position （P〈0.01）and lowest in the posterior position（P〈0. 001）, and no difference was noted between the left and right positions（P=0. 571 ）. The functional urethral length shows longest in the posterior position（〈0.01） and shortest in the anterior position（P〈0.01）, and no difference was noted between left and right positions（P=0. 717）. The majority of RUPP curves are parabolic curve, high pressure zone and highest MUCP locating on the middle or mid-distal junction part of the urethra. Conclusions：The present study demonstrated that RUPP having significant anisotropic variations at the anterior and posterior positions and showing sym- metric characteristic at the lateral positions. The features of the pressure distribution of the RUPP correspond to the anatomical and physiological features of the female urethra.