尿动力学检查在女性压力性尿失禁诊治中的价值(附20例报告)

Effects of urodynamic studies on diagnosis and treatment of female stress urinary incontinence(report of 20 cases)

目的 探讨尿动力学检查对女性压力性尿失禁 (SUI)诊断中的价值。 方法 对 2 0例SUI ,进行全面的尿动力学检查 (包括应力性漏尿点压力测定 )。 2 0例中不稳定膀胱者 6例 (30 % )。Ⅲ型 7例 ,混合型 (Ⅲ型 /Ⅱ型 ) 10例 ,Ⅱ型 3例。 16例行手术治疗 ,其中改良Gittes术 12例 ,带涤纶片吊带术 3例 ,MMK术加阴道后壁修补 1例。 结果 16例手术患者随访 8～ 4 0个月 ,平均 31个月。MMK术加阴道后壁修补 1例和吊带手术者 3例均无复发。改良Gittes术 12例中 3例 (Ⅲ型 1例 ,混合型 2例 )于 1年左右复发。 结论 尿动力学检查有助于SUI的诊断和鉴别诊断 ,对SUI的术式选择有指导意义。

Objective To evaluate the effects of urodynamic studies on diagnosis and treatment of female stress urinary incontinence (SUI). Methods Urodynamic studies including the determination of stress leakage spot pressure were performed in 20 cases of SUI.Of them 6 cases (30%) had detrusor instability.Based on the types of SUI pathogenesis,7 cases were of Type Ⅲ,10 cases of mixed type (Type Ⅲ/Type Ⅱ) and 3 cases of Type Ⅱ.Of the 20 cases,16 underwent operation,including modified Gittes suspension in 12,sling with polyester pieces in 3 and MMK plus posterior vaginal wall repair in 1. Results The 16 operatied patients were followed up for 8～40 months(mean,31 months).The patients undergoing MMK or Sling operation were cured.But 3 patients (1 of Type Ⅲ and 2 of Type Ⅲ/Ⅱ) undergoing modified Gittes suspension had relapse (recurrence rate,25%). Conclusions Urodynamic studies are important to the diagnosis and differential diagnosis of SUI,and are indicative for choice of operation approaches.