盆底三维超声对压力性尿失禁女性膀胱颈的观察

Dynamic observation of the bladder neck with transperineal ultrasonography in the diagnosis of female stress urinary incontinence

经会阴盆底三维超声观察压力性尿失禁女性膀胱颈的动态位置变化。方法选取2015年1月至2017年6月在我院诊断为压力性尿失禁的女性120例(病例组),同期选取无症状健康女性70例(对照组)。测量静息状态及Valsalva动作后的膀胱颈距离参考线位置,参考线上为正数(+),参考线下为负数(-),计算膀胱颈移动度,比较两组女性在静息状态和Valsalva动作后的膀胱颈相对位置。结果静息状态病例组膀胱颈位置为距离参考线(2.63±0.37)cm,对照组为距离参考线(2.51±0.45)cm,Valsalva动作后病例组膀胱颈位置为距离参考线(-1.83±1.07)cm,对照组为距离参考线(1.21±0.65)cm,病例组膀胱颈移动度为(3.11±1.34)cm,对照组为(1.81±0.75)cm。静息状态两组膀胱颈位置比较差异无统计学意义(P>0.05),Valsalva动作后两组膀胱颈位置及膀胱颈移动度结果比较差异有统计学意义(P<0.05)。结论经会阴盆底超声动态检查显示,压力性尿失禁女性Valsalva动作后的膀胱颈位置明显降低、膀胱颈移动度增大。

Objective To observe the dynamic changes of bladder neck with transperineal ultrasonography in women with stress urinary incontinence(SUI).Methods A total of 120 SUI cases treated during Jan.2015 and Jun.2017 were enrolled in the case group,and 70 healthy subjects served as the control group.The position of the bladder neck was measured with ultrasound in the resting state and on maximum Valsalva.If the bladder neck was above the line of reference,the result was positive,while if it was below the line of reference,the result was negative.The bladder neck descent(BND)was calculated,and the relative positions of the bladder neck were compared between the two groups.Results In the resting state,the bladder neck was(2.63±0.37)cm to the line of reference in the case group and(2.51±0.45)cm in the control group(P>0.05).On maximum Valsalva,the bladder neck was(-1.83±1.07)cm in the case group and(1.21±0.65)cm in the control group,and the BND was(3.11±1.34)cm in the case group and(1.81±0.75)cm in the control group(P<0.05).Conclusion Transperineal ultrasonography indicates that on maximum Valsalva,the bladder neck is lower in position and BND is increased in women with SUI.