| Objective: To investigate the clinical application and value of urodynamic test of thedisease in the pelvic floor dysfunction. Methods: From October2009to October2012,264patients with pelvic floor dysfunction without lower urinary tract organic disease ornervous dysfunction were enrolled in this study from our hospital. According to prolapsedegree, patients were classified into different groups (Ⅱ~Ⅳ degree groups), using strictinternational POP-Q score. All patients underwent urodynamic testing, determination ofthe urodynamic parameters, different degrees of prolapse urodynamic parameters changes,affects on the lower urinary tract function, and the relationship of urodynamic parametersin women and the stress urinary incontinence (SUI) grading. The statistical analysis wascarried out according to the results. Results:264cases of pelvic organ prolapse and68cases of that combined stress urinary incontinence, patients general conditions andurodynamic parameters by single factor and ordered Logistic regression analysis:in singlefactor analysis, patients general condition including age, body mass index (BMI), parity,duration, menopause, and factors such as the impact of differences in pelvic organprolapse were statistically significant (P <0.05). Urodynamic parameters, maximum flowrate value, respectively (27.44±0.96) ml/s,(21.20±0.71) ml/s,(13.44±1.00) ml/s,residual urine measure were (55.26±7.66) ml,(70.26±5.52) ml,(115.45±8.30) ml,maximum detrusor pressure were(48.68±2.18) cmH2O,(61.89±6.73) cmH2O,(72.87±3.42) cmH2O, abdominal leak point pressure were (91.18.±3.31) cmH2O,(71.42±5.61)cmH2O,(87.33±4.72) cmH2O, maximum bladder capacity were(450.60±9.38) ml,(418.27±9.07) ml,(380.15±13.81) ml, and urodynamic examination results, detrusorinstability incidence were14.9%(10/67),43.3%(29/67),41.8(28/67), bladder outletobstruction incidence were10%(10/100),40%(40/100),50%(50/100), the incidence of stress urinary incontinence were73.5%(50/68),17.6%(12/68),8.8%(6/68) With theincrease in the degree of prolapse, the indicators have different changes, and thedifferences were statistically significant (P <0.05), which may affect the prolapse relatedfactors into the analysis of ordinal Logistic regression model: BMI, The course of thedisease and pelvic organ prolapse highly correlated. Patients (68/264) of the total overallrate of stress urinary incontinence account for25.8%of the Pop, Stamey grading isdivided into:27cases on level1(coughing, sneezing, sports contour abdominal pressureincreased incontinence),27cases on level2(urinary incontinence in the medium to walkup and down stairs, and the day-to-day activities, such as increased abdominal pressure),14cases on level3(body position changes slightly increased abdominal pressure onurinary incontinence, nearly complete incontinence). Related factors may affect stressurinary incontinence by single factor analysis show that the impact of differences infactors such as age, menopause time of stress urinary incontinence were statisticallysignificant (P <0.05). Into an ordered Multivariate Logistic regression analysis showedthat history of chronic diseases, duration of stress urinary incontinence severity.Comparison of each urodynamic parameters,among which abdominal pressure leak pointpressure value decreases with the severity of stress urinary incontinence, the differencewas statistically significant (P <0.05). Pop to merger subjective lower urinary tractsymptoms make up55.7%of the total pop patients (147/264), and among the mutualcontrast of each degree of prolapse, the difference in number of cases of subjective lowerurinary tract were statistically significant. Conclusion: With the severity of the POP,urodynamic parameters change to varying degrees, pop patients to merger varying degreesof lower urinary tract symptoms and is closely related with stress urinary incontinence.Therefore, urodynamic test has a very important role in women POP merger urinary tractsymptoms, and diagnosis and treatment of patients with stress urinary incontinence, weshould make a detailed assessment of urinary function before the operation, lack of payingattention may affect treatment effect. |
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