Urethral failure is a critical factor in female urinary incontinence. Now what?
Urethral failure is a critical factor in female urinary incontinence. Now what?
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DOI：
10.1002/nau.24875
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发表时间：
2022-03
影响因子：
2
通讯作者：
DeLancey JOL
中科院分区：
文献类型：
--
作者：
Hokanson JA;DeLancey JOL
NIDDK最近赞助了一个为期七周的虚拟系列研讨会，题为“女性尿道功能和失败：推进泌尿生殖系统疾病的基础和转化研究”。在这次多国会诊中，讨论了揭示尿道所起关键作用的最新证据，评估了尿道知识的状态，并确定了我们对这一关键器官的理解中的重要知识空白。本丛书的摘要、要点和已查明的研究差距可作为补充材料提供。这次国际科学家聚会强调需要重新评估当前强调紧迫性尿失禁（UUI）的逼尿肌功能异常和压力性尿失禁（SUI）的尿道支持不良的双因素理论，并转向包括尿道衰竭在压力性尿失禁和紧迫性尿失禁中所起作用的三因素理论（图1）。如果尿道是维持尿失禁的关键，那么问题就变成了，“现在怎么办？”为什么尿道这么长时间没有受到科学的审视？这可能是因为广泛持有的失禁双因素理论与我们当时可用的治疗方法是平行的。然而，从20世纪60年代开始，越来越多的证据表明，尿失禁妇女的尿道功能要低得多（2,3），随后进行了许多关于该参数的研究。然而，在不改变尿道压力的情况下，SUI的尿道支撑手术是相当成功的（4,5），而测量尿道压力则没有
The NIDDK recently sponsored a seven-week virtual seminar series titled:“Female Urethral Function and Failure: Advancing Basic and Translational Research for Genitourinary Conditions.” In this multinational consultation, recent evidence revealing the key role played by the urethra was discussed, the state of urethral knowledge evaluated, and important knowledge gaps in our understanding this critical organ identified. An executive summary of the series, as well as key points and identified research gaps, are available as supplementary material. This international gathering of scientists underscored the need to re-evaluate the current two-factor theory that emphasizes abnormal detrusor function for urgency urinary incontinence (UUI) and poor urethral support for stress urinary incontinence (SUI) and to move to a three-factor theory that includes the role that urethral failure plays in both stress and urge incontinence (Figure 1). If the urethra is critical to maintaining continence, then the question becomes,“now what?” Why has the urethra escaped scientific scrutiny for so long? It is probably because the widely held two-factor theory of incontinence paralleled the treatments we had available at the time. However, starting in the 1960’s evidence began accumulating that urethral function was much lower in incontinent women (2, 3) and many studies of this parameter followed. However, the fact that urethral support operations for SUI were reasonably successful without changing urethral pressure (4, 5) and the fact that measuring urethral pressure didn’t
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影响因子：
4.3
作者：
Lo, TS;Wang, AC;Soong, YK
通讯作者：
Soong, YK
DOI：
10.1111/j.1471-0528.1983.tb06764.x
发表时间：
1983-01-01
期刊：
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY
影响因子：
--
作者：
HILTON, P;STANTON, SL
通讯作者：
STANTON, SL
影响因子：
2
作者：
Kenton, Kimberly;Lowenstein, Lior;Brubaker, Linda
通讯作者：
Brubaker, Linda
影响因子：
1.2
作者：
McGee, Meredith J.;Grill, Warren M.
通讯作者：
Grill, Warren M.
影响因子：
1.6
作者：
Vereecken, RL
通讯作者：
Vereecken, RL