女性盆腔器官脱垂对尿动力学的影响

目的探讨盆腔器官脱垂(POP)与尿动力学改变之间的关系。方法对2006年2月至2010年9月就诊于中国医科大学附属盛京医院门诊及病房的355例盆腔器官脱垂且无下尿路器质性病变患者,严格采用国际POP-Q评分标准,根据脱垂程度进行分组(Ⅱ～Ⅳ度组)。所有患者进行尿动力检测,判断其脱垂对下尿路影响情况,并对其结果进行统计分析。结果盆腔器官脱垂患者中有76.3%(271/355)尿动力学检测可发生改变,其中以膀胱膨出为主者232例,占85.6%(232/271);以直肠膨出、子宫脱垂为主者共39例,仅占14.4%(39/271)。Ⅱ～Ⅳ度POP患者客观尿动力学检测发生变化的比率分别为32.9%(28/85),85.9%(146/170),97.0%(97/100)。结论 POP本身多伴有不同程度尿动力学改变,膀胱膨出是尿动力指标改变的主要因素。因此,POP患者尿动力检查在临床诊疗中十分重要,术前应详细评估下尿路功能,如不给予足够重视,可能会影响治疗效果。

Effect of pelvic organ prolapse on urodynamics

Objective To analyze the relationship between the change of urodynamics and pelvic organ prolapse(POP).Methods 355 cases with only POP who received treatment in our department of outpatients and inpatients between February 2006 and September 2010 were enrolled in this study.Pelvic Organ Prolapse Quantitative Examination(POP-Q) was administered for the patients who were categorized into different groups according to POP-Q outcomes.Urodynamics was assessed to analyze its effect to lower urinary tract function for all patients.Results Urodynamics was abnormal in 76.3%(271/355)cases of POP.232 cases with vesicocele had abnormal urodynamics(85.6%,232/271),while urodynamics was abnormal in 14.4%(39/271) cases with rectocele or uterine prolapse.32.9%(28/85),85.9%(146/170) and 97.0%(97/100)POP patients in Stage Ⅱ,Ⅲ and Ⅳ presented abnormal urodynamics respectively.Conclusion POP is often accompanied with abnormal urodynamics.The incidence of abnormal urodynamics is closely correlated with the gravity of POP in some degree.Vesicocele is a major factor that determines the change of urodynamics.Urodynamics test is very important in diagnose and treatment of POP,which is necessary to assess the lower urinary tract function before operation.If not,it will affect the effect of treatment.