Urologia internationalis · 2007
Comparison of cystographic findings of intrinsic sphincteric deficiency with urethral hypermobility causing urinary incontinence.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Park Sang Woo, Sung Deuk Jae, Choi Eun Jung, Lee Min Woo, Kim Young Jun, Yi Jeong Geun, Jeon Hae Jeong, Park Jeong Hee
Аннотация
OBJECTIVES: To evaluate the usefulness of standing and lateral cystograms for differentiation of intrinsic sphincter deficiency (ISD) from urethral hypermobility (UH) causing stress urinary incontinence (SUI).
MATERIALS AND METHODS: 67 female patients with urinary incontinence undergoing measurement of the Valsalva leak point pressure (VLPP) were included. 14 patients with VLPP <60 cm H2O were operated for ISD causing SUI while 53 patients with VLPP >100 cm H2O were operated for UH causing SUI. Three radiologists compared the cystographic findings.
RESULTS: The changes in posterior urethrovesical angle (PUVA) between stress and resting states were 12 +/- 7.5 degrees in ISD causing SUI and 32.8 +/- 12.7 degrees in UH causing SUI, and showed a statistically significant difference (p < 0.01). The beaking signs of the vesical neck on anteroposterior (AP) projection of the cystogram during a resting state were seen in 76% of ISD causing SUI. The difference was also statistically significant (p < 0.01). The existence of cystocele or the mean PUVA in two groups did not show a statistically significant difference.
CONCLUSION: ISD should be considered in female patients with symptoms of urinary incontinence where there are changes in PUVA <20 degrees on a lateral cystogram between a stress state and resting state in addition to the beaking sign of the vesical neck during a resting state.
MATERIALS AND METHODS: 67 female patients with urinary incontinence undergoing measurement of the Valsalva leak point pressure (VLPP) were included. 14 patients with VLPP <60 cm H2O were operated for ISD causing SUI while 53 patients with VLPP >100 cm H2O were operated for UH causing SUI. Three radiologists compared the cystographic findings.
RESULTS: The changes in posterior urethrovesical angle (PUVA) between stress and resting states were 12 +/- 7.5 degrees in ISD causing SUI and 32.8 +/- 12.7 degrees in UH causing SUI, and showed a statistically significant difference (p < 0.01). The beaking signs of the vesical neck on anteroposterior (AP) projection of the cystogram during a resting state were seen in 76% of ISD causing SUI. The difference was also statistically significant (p < 0.01). The existence of cystocele or the mean PUVA in two groups did not show a statistically significant difference.
CONCLUSION: ISD should be considered in female patients with symptoms of urinary incontinence where there are changes in PUVA <20 degrees on a lateral cystogram between a stress state and resting state in addition to the beaking sign of the vesical neck during a resting state.