盆腔器官脱垂对女性尿动力性应激性尿失禁患者排尿动力学的交互作用。

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

Urologia Internationalis Pub Date : 2025-10-07 DOI:10.1159/000548733

Bülent Çetinel, Göktuğ Kalender, Muhammet Demirbilek, Sinharib Çitgez, Günay Can

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引用次数: 0

摘要

前言：探讨盆腔器官脱垂（POP）对女性尿动力性应激性尿失禁（USUI）患者排尿动力学的交互作用。自由尿流曲线模式（FUFCP）标准用于膀胱出口梗阻（BOO）和逼尿肌活动不足（DU）的定义。材料与方法：对362例女性非神经源性USUI患者进行患者档案回顾，经排除标准后，178例女性纯USUI患者符合研究条件。USUI患者分为三组；1组无脱垂（w/o）， 2组轻度脱垂，3组中度/重度脱垂。比较三组患者的特征、压流表现和FUFCP。结果：178例患者中位年龄55岁（47 ~ 65岁），无脱垂61例（34.3%），轻度脱垂95例（53.4%），中重度脱垂22例（12.3%）（p=0.571）。有或无POP的USUI患者的压力-流量数值无统计学差异（Qmax p=0.104, PdetQmax p=0.587）。有序logistic回归分析结果显示，自由尿流时空尿量较小（p=0.037），非钟形FUFCP (p= 0.006)，空后残尿量（PVR）较大（p=0.001），尿动力学诊断BOO频率较高（p= 0.046）是第三组患者独立的显著尿动力学特征。第1组以钟型型多见（62.3%），第3组较少见（18.2%）。结论：在本研究中使用新的FUFCP标准，随着POP严重程度的增加，从钟形到长时间/间歇性模式的明显转变是显而易见的。尽管逼尿肌压力指标变化不大，但同时存在USUI和中重度POP的患者尿动力学BOO发生率更高，支持将FUFCP纳入评估的构建有效性。

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Interactive effect of pelvic organ prolapse on voiding dynamics of female patients with urodynamic stress incontinence.

Introduction: To determine the interactive effect of pelvic organ prolapse (POP) on voiding dynamics of female patients with urodynamic stress incontinence (USUI). Free urine flow curve pattern (FUFCP) criterion was implemented to bladder outlet obstruction (BOO) and detrusor underactivity (DU) definitions.

Materials and methods: Patient file review of 362 female patients with non-neurogenic USUI was conducted, and after exclusion criteria 178 female patients with pure USUI were eligible for the study. Patients with USUI were divided into three groups; Group 1 without (w/o) prolapse, Group 2 with mild, and Group 3 with moderate/severe prolapse. The patient characteristics, pressure flow findings, and FUFCP's were compared between three groups.

Results: Of 178 patients with a median age 55 (47-65), 61 (34.3%) did not have any prolapse, 95 (53.4%) had mild, and 22 (12.3%) had moderate/severe POP (p=0.571). No statistically significant difference was determined between pressure-flow numeric values in USUI patients with or w/o POP (p=0.104 for Qmax, and p=0.587 for PdetQmax). Ordinal logistic regression analysis results showed that smaller amount of voided volume during free urine flow (p=0.037), non-bell shaped FUFCP (p = 0.006), larger amount of post void residual urine volume (PVR) (p=0.001), and more frequent urodynamic diagnosis of BOO (p = 0.046), were the independent significant urodynamic features of the patients in Group 3. Bell shaped pattern was the most frequent pattern in Group 1 (62.3%) while this pattern was infrequent in Group 3 (18.2%).

Conclusions: Using the new FUFCP criterion in the present study, a marked shift from bell-shaped to prolonged/intermittent patterns with increasing POP severity was evident. Although detrusor pressure metrics changed little, patients with coexistent USUI and moderate/severe POP had more frequent urodynamic BOO, supporting the construct validity of incorporating FUFCP into the evaluation.

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来源期刊

Urologia Internationalis 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

6.20%

发文量

审稿时长

3-8 weeks

期刊介绍： Concise but fully substantiated international reports of clinically oriented research into science and current management of urogenital disorders form the nucleus of original as well as basic research papers. These are supplemented by up-to-date reviews by international experts on the state-of-the-art of key topics of clinical urological practice. Essential topics receiving regular coverage include the introduction of new techniques and instrumentation as well as the evaluation of new functional tests and diagnostic methods. Special attention is given to advances in surgical techniques and clinical oncology. The regular publication of selected case reports represents the great variation in urological disease and illustrates treatment solutions in singular cases.