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긴장성 요실금에서의 경회음부 초음파술
Introital UItrasonography in Female Urinary Incontinence

원영철    (울산대학교 의과대학 비뇨기과학교실  );
  • 초록

    Purpose : To evaluate the usefulness of introital ultrasonography in the assessment of female urinary incontinence. Materials and Methods : Introital ultrasonography was performed in fifteen patients with stress urinasy incontinence(mean age 50) and six patients without symptoms of incontinence(mean age 37). Using a sagittal section of the anterior pelvis in the plane of the symphysis pubis the posterior urethrovesical angle, the pubourethral distance and the pubo-yretgrak abgle were measured at rest and during stree(Valsalva's maneuverstate). The student T-test and the ANOVA test were used in statistical analysis. Results : The posterior urethrovesical angles of the controls were 125.3 $^{\circ}$ ( $\pm$ 10.9) at rest and 125.7 $^{\circ}$ ( $\pm$ 7.6) during stress. In the patients, the corresponding angles were 135.3 $^{\circ}$ ( $\pm$ 11.3) and 139.6 $^{\circ}$ ( $\pm$ 10.8). The posterior urethrovesical angles increased 0.3 $^{\circ}$ ( $\pm$ 4.7) in the controls and 5.6 $^{\circ}$ ( $\pm$ 4.0) in the patients(p=0.018). In the controls, thepubo-urethral distances were 21.8mm( $\pm$ 5.8) at rest and 18.2mm( $\pm$ 7.1) during stress, while in the patients the sedistances were 18.4mm( $\pm$ 3.9) and 12.6mm( $\pm$ 4.4). The pubo-urethra distance decreased 3.5mm( $\pm$ 1.5) in the controlsand 5.8mm( $\pm$ 2.3) in the patients(p=0.039). In the patients with mild incontinence(Gradel), the posterior urethrovesical angles increased 3.4 $^{\circ}$ ( $\pm$ 2.8) : 132.3 $^{\circ}$ ( $\pm$ 12.5) at rest and 135.6 $^{\circ}$ ( $\pm$ 12.8) during stress. In the patients with moderate incontinence(Grade II), the angles increased 8.1 $^{\circ}$ ( $\pm$ 3.8) : 136.0 $^{\circ}$ ( $\pm$ 6.5) at rest and 144.1 $^{\circ}$ ( $\pm$ 5.9) during stress. The change of the posterior urethrovesical angle was related to the grade of urinary incontinence in the patients(p


  • 주제어

    Urine, incontinence .   Bladder, US .   Urethra, US.  

  • 참고문헌 (17)

    1. Clinical application of transrectal ultrasound for the investigation of the incontinuence patient , Richmond DH;Sutherst JR , Brit J Urol / v.63,pp.605,
    2. Role of ultrasound in urinary incontinence evaluation , Bergman A;Vermesh M;Ballard CA;Platt LD , Urology / v.33,pp.443,
    3. Transrectal ultrasound versus cystography in the evaluation of anatomical stress urinary incontinence , Bergman A;McKenzie CJ;Richmond J;Ballard CA;Platt LD , Br J Urol / v.62,pp.228-234,
    4. Transrectal sonographic voiding cystourethro-graphy : studies in neuromuscular bladder dysfunction , Shapeero L;Friedland G;Perkash I , Am J Radiol / v.141,pp.83-90,
    5. Assessment of female urinary incontinence by introital sonography , Koelbl H;Brenaschek G;Deatinger J , J Clin Ultrasound / v.18,pp.370-374,
    6. Urinarty incontinence in the female , Shortilefe LMD;Stamey TA;Walsh PC(ed);Gittes RF(ed);Perlmutter AD(ed);Stamey TA(ed) , Campbell's Urology. (5th ed) / v.3,pp.2680-2711,
    7. Urodynamics in women with stress urinary incontinence , Bhatia NN;Ostergard DR , Obstet Gynecol / v.60,pp.552-559,
    8. Transrectal sonographic cystourethro-graphy : studies in stress urinary incontinence , Chang-H-C;Chang S-C;Kuo H-C;Tsai T-C , Urology / v.36,pp.488,
    9. Urethral axis and sphincteric function , Fantl JA;Hurt WG;Bump RC , Am J Obstet Gynecol / v.155,pp.554-558,
    10. Potential use of ultrasound in place of x-ray fluoroscopy in urodynamics , Brown MC;Sutherst JR;Murruy A;Richmond DH , Br J Urol / v.57,pp.88-90,
    11. Ultrasonography in urinary incontinence , Bhatia NN;Ostergard DR;McQuown D , Urology / v.29,pp.90-94,
    12. Comparison of ultrasound and lateral chain urethrocystography in the determination of bladder neck descent , Gordon D;Pearce M;Norton P;Stanton SL , Am J Obstet Gynecol / v.160,pp.182-185,
    13. A comparative study of perineal ultrasound scanning and urethrocystography in patients with genuine stress urinary incontinence , Koelbl H;Brenaschek G;Wolf G , Arch Gynecol Obstet / v.244,pp.39-45,
    14. 긴장성 요실금 : 적립위 경회음 초음파와 쇠사슬 방광요도조영술의 비교연구 , 한기석;김승협;연종모;한만청;백재승 , 대한초음파학회지 / v.14,pp.59-64,
    15. Chain cystourethrogram and stress incontinence , Kitzmiller JL;Manezer GA;Nebel WA;Lucas WE , Obst Gynec / v.39,pp.333,
    16. Real time ultrasonography in the evaluation of urinary stress incontinence , White RD;McQuown D;McCarthy TA , Am J Obstet Gynecol / v.138,pp.235-227,
    17. Development of a plan for diagnosis and treatdment of urinary stress incontinence , Green TH , Am J Obstet Gynecol / v.83,pp.632-635,

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