女性尿道内口开放与压力性尿失禁的相关性研究

Study on the relationship between female urethral funneling and stress urinary incontinence

目的探讨盆底超声检查尿道内口开放与女性压力性尿失禁(SUI)的相关性。方法以2018年9月至2019年9月在中山三院门诊行经会阴实时三维盆底超声检查的女性为研究对象,其中SUI患者190例,无SUI者742例。观察静息及强力闭呼动作(Valsalva动作)时有无尿道内口开放;对于有尿道内口开放的病例,测量开放的宽度、面积、周长、开放角度、开放长度以及开放长度/尿道长度比值等指标,并分析其与压力性尿失禁的相关性。结果静息状态下,SUI组及对照组均无尿道内口开放。最大Valsalva动作时,SUI组尿道内口开放的比例明显高于对照组(P<0.05),尿道内口开放的宽度、面积、周长、开放角度、开放长度以及开放长度/尿道长度比值均大于对照组(P<0.05)。回归分析显示,尿道内口开放角度与SUI有相关性(OR=1.017,95%CI:1.003~1.031)。结论尿道内口开放与SUI有关,其中内口开放的角度与SUI发病相关。

Objective To investigate the correlation between urethral funneling and stress urinary incontinence(SUI)in women by pelvic floor ultrasonography.MethodsA total of 190 women with stress urinary incontinence and 742 without SUI underwent transperineal real-time three-dimensional pelvic floor ultrasound in the outpatient department of the Third Affiliated Hospital of Sun Yat-sen University from September 2018 to September 2019.The presence or absence of urethral funneling at rest and at maximal Valsalva maneuver was observed.For cases with urethral funneling,the width,area,circumference,opening angle,opening length,and open length/urethral length ratio were measured and analyzed for correlation with stress incontinence.ResultsAt rest,there was no funneling of the endourethral orifice in the SUI group and control group.With maximal Valsalva manoeuvre,the proportion of urethral orifice funneling in the SUI group was significantly higher than that in the control group(P<0.05),and the width,area,circumference,opening angle,opening length,and open length/urethral length ratio were greater than those in the control group(P<0.05).Regression analysis showed that the opening angle of the endourethral orifice was associated with SUI(OR=1.017,95%CI:1.003-1.031).ConclusionsUrethral orifice is associated with SUI,in which the angle of the opening of the endourethral orifice is associated with SUI in women.