首页> 外文期刊>Urology >Bladder neck funneling on ultrasound cystourethrography in primary stress urinary incontinence: a sign associated with urethral hypermobility and intrinsic sphincter deficiency.
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Bladder neck funneling on ultrasound cystourethrography in primary stress urinary incontinence: a sign associated with urethral hypermobility and intrinsic sphincter deficiency.

机译:在原发性应激性尿失禁中进行膀胱膀胱超声检查的膀胱颈漏斗:与尿道活动过度和内在括约肌缺乏症相关的体征。

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OBJECTIVES: To elucidate the implications of bladder neck funneling during straining in primary stress urinary incontinence. METHODS: Ultrasonography was performed in 320 consecutive patients who underwent a full urodynamic study and whose only diagnosis was primary genuine stress incontinence. The ultrasound assessment included measurement of the bladder neck angle at rest and during stress, as well as observation of the development of bladder neck funneling during the Valsalva maneuver. RESULTS: Of 320 study subjects, 111 had funneling of the bladder neck and 209 did not. Subjects with bladder neck funneling during stress had a significantly greater bladder neck angle at rest (P = 0.015) and during stress (P <0.001), greater rotation angle (P <0.001), lower maximal urethral closure pressure (P = 0.002), smaller proximal area under the urethral pressure profile curve (P = 0.002), higher incidence of low Valsalva leak point pressure (<60 cm H(2)O; P = 0.003), larger volume of urine leakage on a pad test (P 0.006), and higher peak flow on a pressure-flow study (P did those without. Bladder neck funneling on ultrasonography had a sensitivity of 59.5% and a specificity of 68.6% for the detection of low leak point pressure. The negative predictive value was 92.8%. CONCLUSIONS: In primary genuine stress incontinence, bladder neck funneling on ultrasound cystourethrography implies the potential coexistence of poor anatomic support and an intrinsic sphincter defect, which require urodynamic investigation to verify. The high negative predictive value is useful in excluding the presence of low leak point pressure.
机译:目的:阐明在紧张性原发性尿失禁劳损时膀胱颈漏斗的含义。方法:对320例接受全面尿动力学检查且唯一确诊为原发性真正的压力性尿失禁的患者进行了超声检查。超声评估包括静止和压力下膀胱颈角的测量,以及在Valsalva动作期间观察膀胱颈漏斗的发展。结果:在320名研究对象中,有111名漏斗了膀胱颈,而209名没有漏斗。在压力下出现膀胱颈漏斗的受试者在休息时(P = 0.015)和在压力下(P <0.001)显着更大的膀胱颈角,更大的旋转角(P <0.001),最大尿道闭合压力更低(P = 0.002),尿道压力曲线下的近端区域更小(P = 0.002),低瓦尔瓦尔漏点压力(<60 cm H(2)O; P = 0.003)的发生率更高,尿垫试验的尿液渗出量更大(P 0.006) )和压力流动研究中较高的峰值流量(P进行了不做的那些。超声检查中的膀胱颈漏斗检测低漏点压力的敏感性为59.5%,特异性为68.6%。阴性预测值为92.8)结论:在原发性真正的压力性尿失禁中,超声膀胱膀胱造影上的膀胱颈漏斗表明不良的解剖学支持和内在的括约肌缺损可能并存,这需要尿流动力学检查来证实,较高的阴性预测价值可用于排除低泄漏点压力的存在。

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