How Does the Urethra Respond to Bladder Filling in Continent and Incontinent Women?
How Does the Urethra Respond to Bladder Filling in Continent and Incontinent Women?
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DOI：
10.1097/spv.0000000000001125
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发表时间：
2022-05-01
影响因子：
1.6
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中科院分区：
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目的：探讨可控和失禁妇女充盈性膀胱测压时的平均尿道压（MUP）。失禁妇女从泌尿妇科诊所招募，如果他们回答“有时”或“总是”的医疗，流行病学和社会方面的老龄化问卷的项目之一。参与者按梅萨评分分为压力性（SUI）或紧迫性（UUI）尿失禁组。大陆妇女是从社区中招募的。使用微尖端导管进行多通道尿动力学检查。在膀胱排空和充盈期间以100 cc增量获得尿道压力曲线。数据用SPSS软件进行统计分析。连续变量比较采用独立t检验或方差分析，分类变量比较采用卡方检验，多变量比较采用线性回归。86名女性（30名控制，56名失禁：37名SUI，19名UUI）参与研究，平均±SD年龄为48±15岁，BMI为31±9。69%为白人，43%为绝经后，80%为经产。大陆女性更年轻（p<0.001），BMI更低（p=0.004）。SUI和控制性尿失禁妇女的平均膀胱测压容量（MCC）高于UUI妇女（430±142，448±101和332±160，p=0.04）。当控制年龄、BMI和产次时，与失禁女性相比，大陆女性在基线时的MUP更高（84±35 cmH 20 vs 62±28 cmH 20;（aR 2 = 0.2，p=0.02）。在充盈过程中，在所有膀胱容量下，大陆女性的MUP比失禁女性高20-30 cmH 20。MUP在大陆（p<0.005）和SUI（P=0.04）中在基线和300cc之间显著增加，但UUI（p=0.48）妇女没有增加。与失禁女性相比，大陆女性的基线MUP更高，膀胱充盈期间MUP增加更大。
To describe mean urethral pressure (MUP) during filling cystometry in continent and incontinent women. Incontinent women were recruited from a urogynecology clinic if they answered “sometimes” or “always” to one of the items on the Medical, Epidemiologic, and Social Aspects of Aging questionnaire. Participants were categorized by MESA scores into stress (SUI) or urgency (UUI) incontinence groups. Continent women were recruited from the community. Multichannel urodynamics were performed using microtip catheters. Urethral pressures profiles were obtained with an empty bladder and at 100cc increments during filling. Data were analyzed in SPSS. Continuous variables were compared with independent t-test or ANOVA, categorical variables with chi-square and multivariable comparisons were made with linear regression. 86 women (30 continent, 56 incontinent: 37 SUI, 19 UUI) with mean±SD age of 48±15 years and BMI of 31±9 participated. 69% were Caucasian, 43% were postmenopausal, and 80% were parous. Continent women were younger (p<0.001) and had lower BMI (p=0.004). Mean cystometric capacity (MCC) was higher in SUI and continent women than in UUI women (430±142, 448±101 and 332±160, p=0.04). Continent women had higher MUP at baseline when controlling for age, BMI and parity (84±35 cmH20 vs 62±28 cmH20; (aR2 = 0.2, p=0.02) compared to incontinent women. During filling, MUPs in continent women were 20-30 cmH20 higher at all bladder volumes than incontinent women. MUP increased significantly between baseline and 300cc in continent (p<0.005) and SUI (P=0.04), but not UUI (p=0.48) women. Continent women have greater baseline MUP and greater increases in MUP during bladder filling than incontinent women.