Removal of transurethral catheter during urodynamics may unmask stress urinary incontinence
Removal of transurethral catheter during urodynamics may unmask stress urinary incontinence
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DOI：
10.1016/s0022-5347(05)65089-6
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发表时间：
2002-05-01
影响因子：
6.6
通讯作者：
Goldman, HB
中科院分区：
文献类型：
--
作者：
Maniam, P;Goldman, HB
目的：Valsalva漏尿点压力的测量可能在压力性尿失禁女性的治疗算法中具有重要作用。然而，一些压力性尿失禁患者在标准尿动力学检查中可能没有渗漏，因此无法确定Valsalva渗漏点压力。我们假设，经尿道导管可以抑制泄漏在urodynamic.Materials和方法：我们评估了21个连续的女性压力性尿失禁的投诉谁没有泄漏的尿动力学研究。进行床边膀胱测压，然后使用6Fr经尿道导管进行尿动力学检查。当压力性尿失禁没有注意到，导管被删除和Valsalva泄漏点压力测量使用intraabdominal pressure cathetrans.Results：没有女人有泄漏的尿动力学研究与导管到位，虽然11 21泄漏后，导管被删除，15泄漏床旁膀胱测压。所有11例导管取出时发生泄漏的患者均在床旁压力测试中显示泄漏。发生泄漏的患者的平均Valsalva泄漏点压力为67 cm。water.Conclusions:有压力性尿失禁病史的患者和床旁压力试验阳性的患者，在尿动力学检查中进行Valsalva操作时没有渗漏，应重复Valsalva操作，并取出导管。这项技术可以揭露压力性尿失禁，并允许Valsalva漏尿点压力的测量。
Purpose: The measurement of Valsalva leak point pressure may have an important role in the treatment algorithm of women with stress urinary incontinence. However, some patients with stress urinary incontinence may not have leakage during standard urodynamic studies and, thus, the Valsalva leak point pressure cannot be determined. We hypothesized that the transurethral catheter may inhibit leakage during urodynamics.Materials and Methods: We evaluated 21 consecutive women presenting with complaints of stress urinary incontinence who failed to have leakage on urodynamic studies. Bedside cystometry was performed, followed by urodynamics using a 6Fr transurethral catheter. When stress urinary incontinence was not noted, the catheter was removed and the Valsalva leak point pressure was measured using the intraabdominal pressure catheter.Results: No woman had leakage on urodynamic studies with the catheter in place, although 11 of 21 had leakage after the catheter was removed and 15 had leakage on bedside cystometry. All 11 patients with leakage at catheter removal showed leakage on bedside stress testing. Mean Valsalva leak point pressure in those with leakage was 67 cm. water.Conclusions: Patients with a history of stress urinary incontinence and those with a positive bedside stress test who do not have leakage during a Valsalva maneuver on urodynamic studies should repeat the Valsalva maneuver with the catheter out. This technique may unmask stress urinary incontinence and allow the measurement of Valsalva leak point pressure.