女性腹圧性尿失禁重症度と静的・動的尿道内圧測定値との相関について

Abstract

58名のSUI患者で尿失禁重症度とmaximum urethral closurepressure(MUCP), functional urethral length(FUL), pressure transmission ratios(PTR)の各因子との関連を調べた。1)MUCPは尿失禁の重症化に伴い有意な低下を認め, 尿失禁重症度の要因の一つを占めると思われた。2)FULは尿失禁の重症化に伴い若干低下する傾向は認めたが, 有意差はなかった。3)PTRは尿失禁の重症化に伴い近位尿道では低下しなかったが, 中部尿道では有意に低下した。尿失禁重症例の方がより尿道括約筋機能が破綻しているためと思われた。4)MUCPおよび中部尿道のPTRともに, グループ間でオーバーラップが存在するため, 尿失禁重症度には他のいくつかのパラメーターが関連していると思われた

The urethral pressure profile (UPP) at rest and under stress was recorded by means of double lumen microtip transducer catheter in 58 females with stress urinary incontinence (SUI). The patients were divided into three groups including mild to moderate SUI patients (n = 29, group 1), severe SUI patients (n = 16, group 2) and very severe SUI patients (n = 13, group 3) according to a one-hour pad test. The functional urethral length (FUL) was divided into four equal lengths and the pressure transmission ratio (PTR) was calculated for each quartile for each female. We examined the correlation of the severity of SUI with urethral pressure parameters: maximum urethral closure pressure (MUCP) at rest and functional urethral length (FUL) at rest and PTR. SUI patients showed a negative association between the severity of SUI and MUCP, but no significant differences in the FUL were seen between the different groups. PTR was shown to be similar in order for all groups of SUI patients showing a linear decrease in the value of the PTR along the FUL. However, we found a negative association between the severity of SUI and PTR (P < 0.05) at the middle part of the FUL (Q3). These findings indicate that there are more defective distal sphincter mechanisms in severe SUI patients than in mild to moderate SUI patients. There was an overlap between the different groups in both MUCP and PTR at the middle urethra (Q3), suggesting that other parameters are related with the severity of SUI.