Urethral pressure measurement in stress incontinence: does it help?
Urethral pressure measurement in stress incontinence: does it help?
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压力性尿失禁的尿道压力测量：有帮助吗？
DOI：
10.1007/s11255-008-9506-9
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发表时间：
2008
影响因子：
2
通讯作者：
A. El
中科院分区：
文献类型：
--
作者：
B. Wadie;A. El
介绍和目的静息尿道压力曲线（UPP），用于评估妇女压力性尿失禁，是常规的许多尿动力学单位。这是费时费力，其诊断价值是有争议的，以及其价值的预测结果的抗尿失禁手术。在此，我们评估其价值的预测结果surgery.Patients and MethodsSixty妇女被随机筋膜吊带或TVT。在术前、术后6个月和每年进行尿动力学检查。在充盈和排尿膀胱测压后，在坐位时进行静息UPP。采用自动导管牵拉，速率为1 mm/s。获得平均读数。结果术前最大尿道闭合压（MUCP）为72.9 ± 27.9cmH2O，功能性尿道长度（FUL）为2.4 ± 0.7cm;末次随访时，分别为71.1 ± 20.7 cmH 2 O和2.7 ± 0.7 cm。悬吊组与TVT组MUCP、FUL值差异无显著性。手术结果与UPP参数的关系无统计学差异。没有显着的影响，手术的成功，随访时间，结果和时间的相互作用超过MUCP（P= 0.82，0.56和0.69，分别）或FUL（P= 0.82，0.11和0.67，分别）。这对后续工作没有帮助，并增加了检查的时间和费用。
Introduction and objectivesThe resting urethral pressure profile (UPP), used for the assessment of women with stress incontinence, is routine in many urodynamic units. It is time- and effort-consuming, and its diagnostic value is controversial, as well as its value in the prediction of outcome of anti-incontinence surgery. Herein, we assessed its value in the prediction of the outcome of surgery.Patients and methodsSixty women were randomized to fascial sling or TVT. Urodynamics were performed preoperatively, 6 months and annually thereafter. After filling and voiding cystometry, resting UPP was performed while sitting. Automated catheter pulling, at a rate of 1 mm/s, was adopted. Averaged readings were obtained. Comparison of maximum urethral closure pressure (MUCP) in success and failure, as well as in sling and TVT, was performed, utilizing ANOVA.ResultsPreoperative MUCP and functional urethral length (FUL) were 72.9 ± 27.9 cmH2O and 2.4 ± 0.7 cm. At last follow-up, they were 71.1 ± 20.7 cmH2O and 2.7 ± 0.7 cm, respectively. The differences between sling and TVT as regards value of MUCP and FUL were not significant. The relationship of the outcome of surgery and UPP parameters showed no statistical difference. No significant effect was shown for the success of surgery, duration of follow-up, and interaction of outcome and time over MUCP (P= 0.82, 0.56 and 0.69, respectively) or FUL (P= 0.82, 0.11 and 0.67, respectively).ConclusionThe routine use of resting UPP has no added value in terms of the prediction of success of incontinence surgery. It does not help with follow-up and adds to the time and cost of the examination.