经会阴四维超声在女性压力性尿失禁诊断中的应用价值

Value of transperineal four-dimensional ultrasound in diagnosis of female stress urinary incontinence

目的探讨经会阴四维超声在女性压力性尿失禁(SUI)诊断中的应用价值。方法应用经会阴四维超声分别观察39例SUI患者(SUI组)和32例正常已生育妇女(对照组)在静息状态和Valsalva动作下的声像图变化情况,测量并比较两组静息状态下的尿道长度、膀胱逼尿肌厚度,静息状态及最大Valsalva动作下的盆膈裂孔面积、膀胱颈至耻骨联合后下缘的垂直距离、膀胱尿道后角及尿道旋转角,计算膀胱颈移动度。结果静息状态时,两组膀胱颈至耻骨联合下缘的垂直距离比较,差异无统计学意义(P=0.426)。Valsalva动作下SUI组膀胱颈至耻骨联合下缘的垂直距离、膀胱尿道后角及盆膈裂孔面积与对照组比较,差异均有统计学意义(均P<0.05)。两组膀胱颈移动度和尿道旋转角比较,差异均有统计学意义(均P<0.05)。结论经会阴四维超声可动态评估SUI患者的盆底解剖结构和功能,具有重要的临床价值。

Objective To investigate the application value of transperineal four-dimensional ultrasound in diagnosis of female patients with stress urinary incontinence. Methods Transperineal four-dimensional ultrasound was performed on 39 cases of female patients with stress urinary in continence（SUI group）and 32 cases of normal women with childbearing history（control group）.The length of urethra and the thickness of the bladder detrusor were taken measured in the resting condition.The pelvic diaphragm hiatal area,the vertical distance from vesical neck to the edge of the pubic symphysis,posterior angle of bladder urethral,urethral rotation angle were measured under the resting and tension condition.The bladder neck movement was calculated.Results No statistical difference of the vertical distance from vesical neck to the edge of the pubic symphysis was found between SUI group and control group under resting condition（P=0.426）.The vertical distance from vesical neck to the edge of the pubic symphysis,posterior angle of bladder urethra and the pelvic diaphragm hiatal area in SUI group were significantly greater than those in control group（all P〈0.05）.The bladder neck movement and urethral rotation angle in SUI group were significantly higher than those in control group（all P〈0.05）. Conclusion The transperineal four-dimensional ultrasound can evaluate female stress urinary incontinence in patients with pelvic floor anatomy and function dynamically,and is worthy of clinical application.