The Application Of Detrusor Isovolumetric Test In Female Stress Urinary Incontinence

BackgroundStress urinary incontinence?SUI?is a common disease in middle-aged and elderly women.Suspension of the middle urethra is an effective method for the treatment of SUI.The patients with detrusor contraction weakness have the risk of clean intermittent catheterization after a long time.While,evaluation of bladder function by cystometry?CMG?is usually with the defective illusion of contraction weakness.Thus,accurate assessment of detrusor dysfunction is very important.Detrusor isovolumetric test?DIT?is the gold standard for assessing detrusor function,which refers to the detrusor contractility under the condition of constant bladder volume.However,the application of DIT in the assessment of bladder detrusor function in SUI patients is poorly adequent.ObjectiveTo explore the value of detrusor isovolumetric test?DIT?in the diagnosis and treatment of SUI in female.MethodsA total of 86 SUI patients with suspected detrusor contraction weakness diagnosed by preoperative CMG were enrolled in this study,aged 37 to 68 years old,duration of 2 to 16 years.With DIT methods to evaluate their bladder function again,compare the difference of first sensation cystometry capacity,maximum cystometric capacity,bladder compliance and maximum detrusor pressure between the two methods.Group?who was diagnosed as normal detrusor function with DIT method underwent TOT surgery.Select 90 normal SUI patients as control group?,diagnosed as normal detrusor function with CMG method.Observe surgery effect of the two groups.SPSS 21.0 was used for statistical analysis.There were statistically differences if P value<0.05.ResultsWith DIT detection,there were 65 cases showed normal detrusor function of the86 cases?75.6%?.The maximum detrusor pressure with DIT was?31.2±12.9?cmH₂O versus?11.7±3.1?cmH₂O with cystometry?P<0.05?.There were no significant differences in first sensation cystometry capacity,maximum cystometric capacity and bladder compliance?P<0.05?.In group?,56 cases were cured and 7 cases were improved.The effective rate was 96.9%.7 cases with groin pain,3 cases with dysuria,the postoperative complication rate was 15.3%.In group?,78 patients were cured and 9 were improved.The effective rate was 96.6%.Ten patients with groin pain,nine patients with dysuria,the complication rate was 15.5%.There was no statistical difference in both surgical efficacy and incidence of complications of the two groups.Following up six months after operation,The follow-up rate was 95.4%in group?and 92.2%in group?.There were no significant differences in postoperation effective rate after six months,which were over 95%of the two groups?X²=0.10,P=0.95?.ConclusionDIT is a valuable method to evaluate the bladder function of female SUI,and provides reasonable guidance of treatment options for female SUI patients.