| Background:More and more women are suffering from urinary incontinence in working, studying and psychological aspects. Duing to differences of culture conception, knowledge of disease and other factors, many women are shy to or do not think it is necessary to see a doctor. So the incidence and prevalence are usually undervalued. By the means of epidemiologic research, treatment, basic studies, urinary incontinence in women has became a worldwide difficult problem which effects their families, working, life quality, even the development of our society, valued by more and more countries gradually.The International Continence Society (ICS) defines the symptom of urinary incontinence as "the complaint of any involuntary loss of urine". There are six types of urinary incontinence,including stress urinary incontinence(SUI), urge urinary incontinence(UUI), mixed urinary incontinence(MUI), overflow urinary incontinence(OUI), functional urinary incontinence, abnormal structure urinary incontinence. And stress urinary incontinence (SUI) is the most common urinary incontinence. The International Continence Society (ICS) defines stress urinary incontinence (SUI) as the involuntary leakage of urine during increases in abdominal pressure in the absence of a contraction which is not caused by pressure of urine from wall of urinary bladder. Its character is that there is no involuntary leakage of urine in normal situation, but the urine will leak involuntarily when abdominal pressure increases because of sneezing or coughing.As a result of several kinds of study methods, object, such as age, area of residence, races, sample size, admission criteria, and exclusion criteria, the incidence and prevalence of urinary incontinence and stress urinary incontinence are different among studies.Stress urinary incontinence (SUI) leads from abnormal urine control mechanism caused by many reasons essentially. In recent years, there are two hypothesis called Hammock Theory and The Integral Theory respectively both of which think that mid-urethral plays a primary role in urine control mechanism. The treatment for stress urinary incontinence focuses on restoration and improvement of urine control function including non-surgical therapy and surgical therapy. There are more than150kinds of surgical therapy for stress incontinence in females including suspension, such as Marshll-Marchetti-Krantz, Burch colposuspension, and midurethral tension-free synthetic slings, such as the tension-free vaginal tape (TVT), trans obturator tape (TOT), outside-in transobturator tape(TVT-O).The biggest progress of these surgical methods is individualized based on different conditions of patients suffering from SUI. Among them, midurethral tension-free synthetic slings have become the most popular procedures for the treatment of stress urinary incontinence in females who displaced Burch colposuspension in modern times depending on light surgery trauma, less operating time, satisfactory short-term or long-term cure rate.The position of mid-urethral in midurethral tension-free synthetic slings in the light of anatomic urethral length in euramerican female adult which is defined as the distance from external urethral meatus to internal urethral meatus. According to euramerican classical anatomy and urology textbooks, the anatomic urethral length is about4cm. In our country, the main range of anatomic urethral length in female adult is3to5cm which is likely to be different from euramerican female adult. Because of these reasons, although short-term or long-term cure rate of stress urinary incontinence are satisfactory when it comes to midurethral tension-free synthetic slings, it is unknown that whether the anatomic urethral length on the basis of euramerican female adult is really suit to Chinese in surgery.Our study is based on the exact anatomic urethral length in Chinese female adult measured by using a Foley catheter and a ruler, meanwhile, we obtain data on age, weight, height, body mass index (BMI), abdomen circumference, menses situation in patients when possible. And then we detect the relationship between anatomic urethral length and height, weight, body mass index (BMI), age, abdomen circumference, and menses situation. Finally, we obtain anatomic urethral length in Chinese female adult supplying for midurethral tension-free synthetic slings procedure and other urethral surgery.ObjectiveThe purpose of this study was to obtain anatomic urethral length in Chinese female adult and set up data on anatomic urethral length supplying for midurethral tension-free synthetic slings procedure and other urethral surgery. What was more, we also detected the relationship between anatomic urethral length and height, weight, body mass index (BMI), age, abdomen circumference, and menses situation.Materials and MethodsBetween Jan2012and Mar2013, a total of185female adult patients took part in this study at the department, Guangzhou First People’s Hospital. Measurements of anatomic urethral length were taken by the means of a Foley catheter and a ruler in185women.Female age, weight, height, body mass index (BMI), abdomen circumference were obtained in185women. Pearson correlation was used to determine the relationship between anatomic urethral length and height, weight, body mass index (BMI), age, or abdomen circumference. The degree of pelvic organ prolapse was examined by using pelvic organ prolapse quantitive examination. Menses information was collected to divide the185women into menopause group and non-menopause group. And then anatomic urethral length were compared between the two groups. Contents:1.The anatomic urethral length in Chinese female adult2.The relationship between anatomic urethral length and height, weight, body mass index (BMI), age, abdomen circumference, and menses situation.ResultsThere were185women included in the final analysis.Anatomic urethral length accorded with normal distribution using test of normality.The mean age of participants was46.7years old with a standard deviation of14.9years old, range from18to82years old. The mean height of participants was1.58m with a standard deviation of0.07m, range from1.38to1.72m. The mean weight of participants was54.8kg with a standard deviation of8.6kg, range from36.0to85.0kg. The mean abdomen circumference of participants was74.3cm with a standard deviation of12.4cm, range from51.0to111.0cm. The mean body mass index (BMI) of participants was21.82with a standard deviation of2.93, range from16.38to30.70. The mean anatomic urethral length of participants was3.62cm with a standard deviation of0.57cm, range from2.5to5.1cm.There were54and131patients divided into menopause group and non-menopause group respectively.There was negative correlation between age and anatomic urethral length (r=-0.227, P=0.002). However, the correlation coefficient is not so obvious, but there was still a downtrend to anatomic urethral length with the age increasing.One-way ANOVA was used to analyze the anatomic urethral length based on different age groups. Compared with18-30year-old group, anatomic urethral length was statistically significant shorter in51-60year-old group (P<0.05). Beside, compared with18-30year-old group, anatomic urethral length was statistically significant shorter in more than61year-old group (P<0.05). The anatomic urethral length is longest in18-30year-old group and shortest in more than61year-old group. Compared with31-40year-old group, anatomic urethral length was statistically significant shorter in more than61year-old group (P<0.05).There are no statistically significant in other groups.No statistically significant correlation was found between anatomic urethral length and height(r=0.088, P=0.232>0.05),No statistically significant correlation was found between anatomic urethral length and weight(r=0.016, P=0.827>0.05),No statistically significant correlation was found between anatomic urethral length and abdomen circumference (r=-0.011, P=0.886>0.05),No statistically significant correlation was found between anatomic urethral length and body mass index (r=-0.038, P=0.606),Compared with non-menopause group(3.67±0.57), anatomic urethral length was statistically significant shorter in menopause group (3.48±0.56)(P<0.05). Based on this result, we concluded that anatomic urethral length was shorter in menopause group than that in non-menopause group. And menopause effected anatomic urethral length.Conclusions1. The mean anatomic urethral length of participants was3.62cm with a standard deviation of0.57cm, range from2.5to5.1cm.2. We could do the midurethral tension-free synthetic slings procedures based on euramerican countries standard, however, we must continue to pay attention to the long-term cure rates and adjust treatment umder different situation.3. There was negative correlation between age and anatomic urethral length (r=-0.227, P=0.002). Although the correlation coefficient is not so high, there was still a downtrend to anatomic urethral length with the age increasing.4. No statistically significant correlation was found between anatomic urethral length and height, weight, abdomen circumference, or body mass index.5. Menopause effected anatomic urethral length. And anatomic urethral length was shorter in menopause women than that in non-menopause women. |
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