摘要
目的探讨超声在女性压力性尿失禁(SUI)及膀胱脱垂分型中的应用价值。方法选取在我院经临床检查、尿道动力学检查证实的180例膀胱脱垂合并SUI的患者(脱垂+SUI组)及同期180例膀胱脱垂患者(脱垂组);另选同期体检的健康女性190例为对照组。经会阴盆底二维超声检查获取各组静息状态下膀胱尿道后角(PUA),以及最大Valsalva动作下膀胱颈下降值(BND)、膀胱后壁最低点下降值及尿道旋转角,比较各组差异。结果脱垂+SUI组、脱垂组PUA、BND、膀胱后壁最低点下降值、尿道旋转角均明显高于对照组,差异均有统计学意义(均P<0.01);脱垂+SUI组膀胱后壁最低点下降值、尿道旋转角均明显低于脱垂组,差异均有统计学意义(均P<0.01)。脱垂+SUI组以Ⅰ、Ⅱ型膀胱脱垂为主。Ⅰ、Ⅱ型膀胱脱垂患者PUA均明显高于Ⅲ型,膀胱后壁最低点下降值、尿道旋转角均明显低于Ⅲ型,差异均有统计学意义(均P<0.01)。结论盆底二维超声能够对膀胱脱垂及其不同类型进行评估和分析。SUI患者的膀胱脱垂以膀胱尿道膨出为主,膀胱尿道后角增大及膀胱颈漏斗的形成是造成SUI的主要原因。
ObjectiveTo explore the application value of ultrasound in the classification of female stress urinaryincontinence(SUI)and bladder prolapse.MethodsA total of 180 cases of bladder prolapse with SUI(prolapse+SUI group)and 180 cases of bladder prolapse at the same time(prolapse group)confirmed by clinical examination and urethrodynamicexamination were selected.190 healthy women who underwent physical examination during the same period were selected ascontrol group.The posterior angle of bladder and urethra(PUA),the decrease of bladder neck(BND),the lowest point ofposterior wall of bladder and the rotation angle of urethra were obtained by two-dimensional ultrasonography,and the results wascompared between groups.ResultsThe decrease of PUA,BND,the lowest point of the posterior wall of bladder and the rotationangle of urethra in the prolapse+SUI group and prolapse group were significantly higher than those in the control group(allP<0.01),and the decrease of the lowest point of the posterior wall of bladder and the rotation angle of urethra in the prolapse+SUI group were significantly lower than those in the prolapse group(all P<0.01).In prolapse+SUI group,typeⅠand typeⅡbladder prolapse were the main type.The PUA of typeⅠand typeⅡwere significantly higher than that of typeⅢ,the lowestpoint of the posterior wall of bladder and the rotation angle of urethra were significantly lower than those of typeⅢ(all P<0.01).ConclusionTwo-dimensional pelvic floor ultrasound can be used to evaluate and analyze bladder prolapse and its differenttypes.Bladder prolapse in patients with SUI is mainly cystourethrocele,the increase of the posterior angle of the bladder andurethra and the formation of the bladder neck funnel are the main causes of stress incontinence.
作者
邓舒昊
江泉
朱一成
张爱
王永兵
周庆华
张渊
DENG Shuhao;JIANG Quan;ZHU Yicheng;ZHANG Ai;WANG Yongbing;ZHOU Qinghua;ZHANG Yuan(Department of Ultrasound,Pudong New Area Peoples’Hospital Affiliated to Shanghai Health University,Shanghai 201200,China)
出处
《临床超声医学杂志》
CSCD
2019年第12期937-939,共3页
Journal of Clinical Ultrasound in Medicine
基金
上海市浦东新区卫生和生育计划委员会青年科技项目(PW2018B-04)
关键词
超声检查
膀胱脱垂
压力性尿失禁
Ultrasonography
Bladder prolapse
Stress urinary incontinence
