Intra-abdominal pressure measurement during ultrasound assessment of women with stress urinary incontinence: a novel model1 Aferição da pressão intra-abdominal durante avaliação ultra-sonográfica de mulheres com incontinência urinária de esforço: um novo modelo
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چکیده
Purpose: To determine the influence of intra-abdominal pressure on the ultrasonographic evaluation of the urethrovesical junction (UVJ) and proximal urethra (PU) in women with stress urinary incontinence (SUI). Methods: This is a prospective cross-sectional study undertaken at the Urinary Incontinence Research Unit (UIRU) of the Universidade Federal de Pernambuco (UFPE). Thirty-six women complaining of SUI underwent perineal ultrasound assessments of the UVJ and PU having the bladder barely empty (< 50 ml of urine) with simultaneous measurement of the intra-abdominal pressure (IAP). An ALOKA ultrasound machine with a 7 MHz vaginal probe was used for the assessments. In order to measure the IAP, an Uromaster MPX616 urodynamic equipment, connected to a 10Fr rectal catheter with a pressure sensitive baloon, was used. Results: The participants’ mean age was 46.4 ± 10.2 years. On maximum straining, the mean IAP was 99.3 ± 51.8 cmH20, varying from 7 to 193 cmH20, and the median was 99.5 cmH20. Twenty-eight of 31 patients with UVJ hypermobility (90.3%) easily showed it with an IAP over 40 cmH20. There was no significant association between the mean IAP measurements on maximum straining and the parameters studied. The IAP did induce a significant elongation of the proximal urethra length over 14 mm up to a cut-off over 80 cmH2O, most likely to increase urethral resistance and pressure profile, thus avoiding urine leakage. However, all 19 women with such a characteristic already presented so with an IAP > 40 cmH2O. Conclusion: There is no need to measure IAP routinely on perineal ultrasound assessments of the UVJ and PU in women with SUI having a barely empty bladder.
منابع مشابه
Diagnostic Accuracy of Anthropometric Indicators in the Prediction of Urinary Incontinence in Physically Active Older Women Acurácia diagnóstica de indicadores antropométricos na predição de incontinência urinária em idosas fisicamente ativas
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1Department of Gynecology and Obstetrics, Ribeirão Preto School of Medicine, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil 2Department of Obstetrics, Gynecology and Reproductive Medicine, Universidade Estadual do Oeste do Paraná, Cascavel, West Paraná, Brazil 3Department of Gynecology, School of Medicine, Universidade de São Paulo, São Paulo, São Paulo, Brazil 4Department of Gyne...
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تاریخ انتشار 2006