经会阴超声对压力性尿失禁合并盆腔脏器脱垂的诊断价值

Diagnostic Value of Trans-perineal Ultrasound for Stress Urinary Incontinence Combined with Pelvic Organ Prolapse

目的探讨经会阴超声对压力性尿失禁(stress urinary incontinence,SUI)合并盆腔脏器脱垂(pelvic organ prolapse,POP)的诊断价值。方法选取2020年7月—2022年4月苏州大学附属常熟医院(常熟市第一人民医院)诊断为SUI合并POP的患者60例为观察组,选取同期同年龄段健康体检者60例为对照组,均采用会阴超声检查,比较两组静息期、张力期各超声参数,并分析各超声参数单独以及联合检测对SUI合并POP患者的诊断效能。结果静息期观察组尿道膀胱后角角度大于对照组,差异有统计学意义(P<0.05)。张力期观察组直肠壶腹距离耻骨联合后下缘距离、肛提肌裂孔左右径及肛提肌裂孔前后径大于对照组,肛提肌厚度小于对照组,差异有统计学意义(P<0.05)。多指标联合诊断SUI合并POP的敏感度、特异度、准确率分别为86.7%、93.3%和90.0%。结论经会阴超声下肛提肌厚度单独诊断SUI合并POP具有一定的诊断价值,同时多项经会阴超声指标联合诊断SUI合并POP则可显著提高诊断意义。

Objective To explore the diagnostic value of transperineal ultrasound for stress urinary incontinence(SUI)combined with pelvic organ prolapse(POP).Methods Sixty patients diagnosed with SUI complicated with POP in Changshu Hospital Affiliated to Soochow University(Changshu First People's Hospital)from July 2020 to April 2022 were selected as the observation group,and 60 healthy physical examination patients of the same age during the same period were selected as the control group.Perineal ultrasonography was performed in all cases.The ultrasound parameters in the resting period and tension period of the two groups were compared,and the diagnostic efficacy of each ultrasound parameter alone and combined detection in patients with SUI complicated with POP was analyzed.Results The Angle of urethrovesical posterior Angle in the resting group was greater than that in the control group,and the difference was statistically significant(P<0.05).The distance from the ampulla of rectum to the posterior and lower margin of pubic association,the left and right diameters of the anal levator hiatus and the anterior and posterior diameters of the anal levator hiatus in the observation group were greater than those in the control group,and the thickness of the anal levator muscle was smaller than that in the control group,and the difference was statistically significant(P<0.05).The sensitivity,specificity and accuracy of multi-index combined diagnosis of SUI combined POP were 86.7%,93.3%and 90.0%,respectively.Conclusion Trans-perineal ultrasound anal muscle thickness alone has a certain diagnostic value in the diagnosis of SUI combined with POP,while multiple trans-perineal ultrasound indexes combined in the diagnosis of SUI combined with POP can significantly improve the diagnostic significance.