Abnormal Clinical and Urodynamic Findings in Women with Severe Genitourinary Prolapse

膀胱頸移動過大及尿道內括約肌功能不良是造成婦女尿失禁的兩大主因。子宮膀胱脫垂的患者，由於腹壓增加時，壓力無法充分地傳導至尿道而導致尿失禁，而且會因脫垂而使尿道後壁張開，造成尿道內括約肌功能不良的情形。本研究統計61位嚴重子宮膀胱脫垂的患者，針對其主觀的泌尿道症狀及客觀的尿路動力學表現，與40位沒有脫垂現象的自願者作比較。結果發現子宮脫垂的患者明顯有較多的泌尿道症狀，包括頻尿、尿急、尿失禁、排尿困難等。此外，在尿路動力學表現上如最大尿流速、膀胱順應性、功能性尿道長度、最大閉鎖尿道壓及壓力傳導比率，子宮膀胱脫垂者皆明顯較差。而值得注意的是，有脫垂現象卻不會尿失禁的患者，有可能在骨盆重建手術後反而發生尿失禁的現象，因而需要一併施行膀胱或尿道懸吊手術。

關鍵字

子宮膀胱脫垂；尿路動力學；泌尿道症狀

並列摘要

In order to investigate the effects of urogenital prolapse on lower urinary tract function, we studied 61 women with stage III to IV pelvic organ prolapse (prolapse group) and 40 volunteers without prolapse (control group). Each woman underwent urinalysis, urinary questionnaire, pelvic examination, and urodynamic study. The incidence of urinary symptoms, including urinary frequency and urgency, stress/urge incontinence, incomplete emptying, difficult voiding and nocturia, were significantly higher in the prolapse group compared to the control group (p ＜ 0.05). Urodymic parameters, including residual urine, total bladder capacity, and bladder volume at strong desire to void, were not significantly different between the two groups (p＞0.05). Maximal flow rate, bladder compliance at urgency, functional urethral length, and maximal urethral closure pressure, however, were significantly higher in the control group compared to the prolapse group (p ＜ 0.05). In addition, there was a higher incidence of poor pressure transmission ratio in the prolapse group (p ＜0.01). The results indicated that severe urogenital prolapse could produce abnormal clinical and urodynamic results.

並列關鍵字

urinary symptom ； urodynamic study ； genitourinary prolapse

國際替代計量

Abnormal Clinical and Urodynamic Findings in Women with Severe Genitourinary Prolapse

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