Urethral Pressure Profile による急迫尿失禁の臨床的観察

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  • URETHRAL PRESSURE PROFILE IN PATIENTS WITH STRESS INCONTINENCE
  • Urethral Pressure Profile ニヨル キュウハク ニョウ

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In order to evaluate urethral sphincteric function, urethral pressure profile (UPP) was studied by the method of Brown-Wickham with modifications in 18 patients with stress incontinence, and 22 normal females were used as control. Concomitantly, cystourethrography combined with the insertion of a watch chain into the urethra was studied in 13 patients with stress incontinence.<br>The results obtained are as follows:<br>1. The greatest urethral pressure (UPmax) was found in the middle portion of the urethra.<br>2. In the control group, the mean value of UPmax was 86.1cm H2O with standard deviation of ±15.9. In general, UPmax showed a tendency to decrease with increasing age. The physiological urethral length determined with UPP was 3.6±0.4cm.<br>3. In the stress incontinence patients, UPmax was 46.7±9.5cm H2O, being significantly lower than that of the controls. The physiological urethral length was 3.1±0.5cm and it was significantly shorter than that of the controls.<br>4. Posterior urethrovesical angle on cystourethrography exceeded 120° in the stress incontinence patients.<br>5. It is of considerable practical significance that bladder pressure rose above UPmax by abdominal pressure during a deep cough in most patients with stress incontinence.<br>These findings indicate that the UPP examination is of actual value in diagnosis for stress incontinence.

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