下尿路三维模型在压力性尿失禁诊治中的应用

Three-dimensionreconstruction of lower urinary tract in diagnosis and treatment of stress urinary incontinence

目的建立女性压力性尿失禁(stress urinary incontinence,SUI)患者下尿路三维模型,探讨SUI的解剖学发病机制及手术机制。方法对20例SUI患者重建下尿路三维模型,观察其形态并测量膀胱颈尿道后角、尿道倾斜度、尿道长度、耻骨联合下缘到尿道的水平距离和膀胱容量。结果下尿路三维模型能够全面显示膀胱形态及尿道走向、下尿路与骨盆的解剖位置关系。经闭孔无张力尿道中段悬吊(tension-free vaginal tape obturate,TVT-O)手术前后,膀胱颈尿道后角(poster urethrovesical angle,PUVA)差异无统计学意义(P=0.068);尿道倾斜度、尿道长度、耻骨联合下缘到尿道的水平距离、膀胱容量差异均有统计学意义(P<0.05)。结论下尿路三维模型的建立能直观、有效地观察并分析SUI患者下尿路形态及解剖位置改变,有助于评价手术疗效、寻找手术失败原因。

Objective To assess the application of three-dimensional reconstructiopm model of lower urinary tract in diagnosis and treatment of stress urinary incontinence （SUI）.Methods Three-dimensional model of lower urinary tract was generated in 20 patients before and after tension-free vaginal tape obturate （TVT-O）.Poster urethrovesical angle （PUVA）, urethral axis of inclination angle, urethra length, distance from pubic symphysis to the tip of coccyx and bladder volume were measured according models.Results There were no significant differences in PUVA （ P =0.068） before and after TVT-O, however, there were significant differences in urethral axis of inclination angle, length of urethra, distance from pubic symphysis to the tip of coccyx and bladder volume （ P 〈0.05） before and after operation.Conclusion Three-dimensional reconstruction of lower urinary tract can be used to analysis morphological changes of the lower urinary tract intuitively and effectively, contributing to evaluate the effect of surgery.