복합성요실금 여성에서 배뇨근과활동성 동반 유무에 따른 근위부 요도질공간 두께의 차이: 예비 연구 = The thickness of the proximal urethrovaginal space in mixed urinary incontinence women with or without detrusor overactivity; a preliminary study

다국어 초록 (Multilingual Abstract)

Purpose: Few studies are available on the role of female anatomical variety such as female urethral length (UL) and urethrovaginal space (UVS) in stress urinary incontinence (SUI) or sexual activity. The aim of this study was to evaluate the usefulness of characterization of female UL and UVS in women with mixed urinary incontinence (MUI).
Materials and Methods: The prospective data was collected for 57 women with MUI and who underwent a midurethral sling operation. Patients with significant cystocele, pelvic floor prolapse or with history of previous pelvic surgery, psycho-neurologic diseases were excluded. All of the patients underwent transvaginal ultrasound with use of a 8 MHz transrectal probe. The subjects were divided into 2 groups according to the presence of detrusor overactivity (DO) by preoperative urodynamic study. Clinical and urodynamic parameters such as proximal UVS, Q-tip, the grade of SUI, the presence of intrinsic sphincter deficiency, maximal urethral closure pressure (MUCP) were compared between the two groups.
The independent t-test was performed for statistical analysis, and the Spearman correlation coefficient for correlation.
Results: Of 57 women, 19 patients had DO (33.3%), 38 did not (66.7%). The women’s median age was 56.3 years and there were no significant differences in the age or symptom duration between the two groups. The proximal UVS (mm, mean±SD) was significantly thinner (0.5±0.1 vs 0.7±0.2, respectively, p<0.001) and the MUCP (cmH2O, mean±SD) was significantly lower (43.8±18.6 vs 59.0±26.0, respectively, p=0.015) in women with DO than in women without DO. There were no significant differences in the UL, the grade of SUI and urge incontinence between the two groups. An intermediate negative correlation (correlation coefficient: -0.440) was found between proximal UVS and DO (p=0.001), and DO showed low negative correlation (correlation coefficient: -0.292) with MUCP (p=0.027).
Conclusions: In this preliminary study, the proximal UVS was significantly thinner and the MUCP was significantly lower in women with DO than in women without DO. These results suggest that women with thinner proximal UVS and lower MUCP are likely to have DO. A large-scale prospective study is needed.

목차 (Table of Contents)

• Abstract 5
• I. 서론 8
• II. 대상 및 방법 10
• 1.대상 10
• 2.방법 11
• 3.통계 분석 12
• III. 결과 13
• IV. 고찰 15
• V. 결론 20
• VI. 참고문헌 21