超声评估女性膀胱脱垂与压力性尿失禁的相关性研究

摘要：目的 探讨女性膀胱脱垂的超声特点及其与压力尿失禁的相关性。方法 2016年4月至2018年4月在本院就诊的90例膀胱脱垂合并SUI的患者，设为脱垂+SUI组。同期来本院就诊的90例膀胱脱垂患者，设为脱垂组（无SUI）。同期来本院体检的女性患者95例，设为对照组（无泌尿系统疾病）。各组均经会阴进行盆底二维超声检查。比较各组超声参数，根据二维超声检测结果，进行膀胱脱垂的分型。比较不同分型膀胱脱垂患者的超声参数。结果 脱垂+SUI组、脱垂组的膀胱尿道后角（PUA）、膀胱颈下降值（BND）、膀胱后壁最低点下降值、尿道旋转角均明显高于对照组，差异均有统计学意义（P<0.01）。脱垂+SUI组的膀胱后壁最低点下降值、尿道旋转角均明显低于脱垂组，差异有统计学意义（P<0.01）。脱垂+SUI组以I、II型膀胱脱垂为主。I、II型膀胱脱垂患者的PUA均明显高于III型，膀胱后壁最低点下降值、尿道旋转角均明显低于III型，差异均有统计学意义（P<0.01）。结论 二维盆底超声能够对膀胱脱垂及其不同类型进行评估和分析。SUI患者的膀胱脱垂以膀胱尿道膨出为主，主要超声表现特点为膀胱尿道后角增大及膀胱颈漏斗的形成。

The relationship between cystocele and stress urinary incontinence in women by ultrasonography

ABSTRACTObjective To explore the relationship between cystocele and stress urinary incontinence in women by ultrasonography.Methods From April 2016 to April 2018, 90 patients with cystocele complicated with SUI treated in our hospital were set as the cystocele+SUI group. In the same period, 90 patients with cystocele who came to our hospital were set as the cystocele group (without SUI). During the same period, 95 female patients who came to our hospital for physical examination were set as the control group (no urinary system disease). Two - dimensional ultrasound examination of pelvic floor was performed by perineum in each group. The ultrasound parameters of each group were compared, and the bladder prolapse was classified according to the results of two-dimensional ultrasound. The ultrasound parameters of patients with cystocele of different types were compared. Results In both the cystocele+SUI group and the cystocele group, the posterior cystourethral Angle (PUA), the descending value of bladder neck (BND), the descending value of the lowest point of the posterior wall of the bladder and the rotation Angle of the urethra were significantly higher than those in the control group, with statistically significant differences (P<0.01). In the cystocele+SUI group, the lowest point of the posterior wall of the bladder and the rotation Angle of the urethra were significantly lower than those in the cystocele group, with statistically significant differences (P<0.01). In the cystocele+SUI group, type I and II cystocele dominated.The PUA of patients with type I and type II cystocele was significantly higher than that of type III, the lowest point of the posterior wall of the bladder and the rotation Angle of the urethra were significantly lower than that of type III, and the differences were statistically significant (P<0.01).Conclusion Two-dimensional pelvic floor ultrasound can be used to evaluate and analyze cystocele and its different types. Cystocele in SUI patients is mainly cystourethrocele, and the main ultrasonic manifestations are enlargement of the posterior Angle of cystourethra and formation of the bladder neck funnel.