The Association of Hiatal Dimensions and Urethral Mobility with Stress Urinary Incontinence
The Association of Hiatal Dimensions and Urethral Mobility with Stress Urinary Incontinence
复制标题
食管裂孔尺寸和尿道活动度与压力性尿失禁的关联
DOI：
10.1002/jum.15748
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发表时间：
2021-05-14
影响因子：
2.3
通讯作者：
Liu, Dan
中科院分区：
文献类型：
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作者：
Shi, Qingling;Wen, Lieming;Liu, Dan
目的探讨咳嗽压力试验（CST）中食管裂孔面积（HA）、膀胱颈活动度和尿道活动度与压力性尿失禁（SUI）的关系。测量HA、膀胱颈活动度和沿尿道沿着六个点的活动度（向量1-6）。队列以2：1的比例随机分为训练队列和验证队列。HA与膀胱颈活动度、尿道活动度和SUI的相关性进行了检验。采用Fisher线性判别分析和受试者操作特征建立预测模型，评估各参数对SUI的预测能力。他们之间在HA、体重指数（BMI）、漏斗、膀胱颈活动度和Vectors 1-6方面存在显着差异。HA与膀胱颈活动度呈正相关。在训练队列中，Valsalva、Vectors 3和BMI上的膀胱颈位置的曲线下面积分别为0.74、0.69和0.66（均P < 0.001）; Functional和Vectors 3预测SUI的优势比分别为18.96和3.65（均P < 0.001）。预测模型包括FUNDERITY，矢量3，和BMI提供了最好的性能在两个coherent.Conclusion预测SUI的HA越大，膀胱颈的灵活性越高。然而，预测SUI的最佳指标是尿道中段活动度，而不是膀胱颈活动度。
Objectives To investigate the association of hiatal area (HA), bladder neck mobility, and urethral mobility during the cough stress test (CST) with stress urinary incontinence (SUI).Methods This was a prospective study of 110 continent and 190 incontinent women using transperineal ultrasound. HA, bladder neck mobility, and the mobility of six points along the urethra (Vectors 1-6) were measured. The cohort was randomly divided at a ratio of 2:1 into a training cohort and a validation cohort. The correlations of HA with bladder neck mobility, urethral mobility, and SUI were tested. The predictive model was yielded by fisher linear discriminant analysis and receiver operating characteristics to assess the parameters' ability to predict SUI.Results Valid data were collected from 177 incontinent women and 105 continent women. Significant differences were identified in HA, body mass index (BMI), funneling, bladder neck mobility, and Vectors 1-6 between them. HA was positively correlated to bladder neck mobility. In the training cohort, bladder neck position on Valsalva, Vectors 3, and BMI had the area under curves of 0.74, 0.69, and 0.66 (all P < 0.001); Funneling and Vector 3 had odds ratios of 18.96 and 3.65 (all P < 0.001), for predicting SUI. The predictive model incorporating funneling, Vectors 3, and BMI provided the best performance in predicting SUI in both cohorts.Conclusion The larger the HA was, the higher the bladder neck mobility. However, it was mid-urethral mobility rather than bladder neck mobility that performed best at predicting SUI.