Abstract：
OBJECTIVE: To compare urethral parameters between cystocele patients with and without stress urinary incontinence (SUI) and explore factors influencing SUI in cystocele patients via dynamic MRI.
METHODS: The two-dimensional parameters evaluated included the paravaginal defects, levator ani muscle defects, urethral length, urethral funnel shape, bladder neck funnel width, bladder neck funnel depth, urethral angle, posterior vesicourethral angle, and anterior bladder protrusion. The three-dimensional parameters included the proximal urethra rotation angle, the distal urethra rotation angle, bladder neck mobility, urethral midpoint mobility, and external urethral meatus mobility. The independent samples t test was used for continuous variables, and the chi-square test was used for categorical variables. Binary logistic regression was used to identify factors independently associated with SUI in cystocele patients.
RESULTS: The baseline parameters were similar between the 2 groups. Cystocele patients with SUI had a significantly higher point Aa (1.63 ± 1.06 cm vs. 0.81 ± 1.51 cm, p = 0.008); more anterior bladder protrusion (33.3% vs. 11.4%, p = 0.017); greater bladder neck mobility (36.38 ± 11.46 mm vs. 28.81 ± 11.72 mm, p = 0.005); mid-urethral mobility (22.94 ± 6.50 mm vs. 19.23 ± 6.65 mm, p = 0.014); and external urethral meatus mobility (22.42 ± 8.16 mm vs. 18.03 ± 8.51 mm, p = 0.022) than did cystocele patients without SUI. The other urethral parameters were similar in the groups (p > 0.05). Binary logistic regression showed that bladder neck mobility was independently associated with SUI in females with cystoceles (odds ratio, 1.06; 95% CI 1.015-1.107; p = 0.009).
CONCLUSIONS: Cystocele patients with SUI have a higher point Aa, more anterior bladder protrusion, and greater urethral mobility than those without SUI. Bladder neck mobility is independently associated with SUI in females with cystoceles.
BACKGROUND: NCT03146195.
METHODS: The two-dimensional parameters evaluated included the paravaginal defects, levator ani muscle defects, urethral length, urethral funnel shape, bladder neck funnel width, bladder neck funnel depth, urethral angle, posterior vesicourethral angle, and anterior bladder protrusion. The three-dimensional parameters included the proximal urethra rotation angle, the distal urethra rotation angle, bladder neck mobility, urethral midpoint mobility, and external urethral meatus mobility. The independent samples t test was used for continuous variables, and the chi-square test was used for categorical variables. Binary logistic regression was used to identify factors independently associated with SUI in cystocele patients.
RESULTS: The baseline parameters were similar between the 2 groups. Cystocele patients with SUI had a significantly higher point Aa (1.63 ± 1.06 cm vs. 0.81 ± 1.51 cm, p = 0.008); more anterior bladder protrusion (33.3% vs. 11.4%, p = 0.017); greater bladder neck mobility (36.38 ± 11.46 mm vs. 28.81 ± 11.72 mm, p = 0.005); mid-urethral mobility (22.94 ± 6.50 mm vs. 19.23 ± 6.65 mm, p = 0.014); and external urethral meatus mobility (22.42 ± 8.16 mm vs. 18.03 ± 8.51 mm, p = 0.022) than did cystocele patients without SUI. The other urethral parameters were similar in the groups (p > 0.05). Binary logistic regression showed that bladder neck mobility was independently associated with SUI in females with cystoceles (odds ratio, 1.06; 95% CI 1.015-1.107; p = 0.009).
CONCLUSIONS: Cystocele patients with SUI have a higher point Aa, more anterior bladder protrusion, and greater urethral mobility than those without SUI. Bladder neck mobility is independently associated with SUI in females with cystoceles.
BACKGROUND: NCT03146195.
摘要：
目的：通过动态MRI比较膀胱膨出伴和不伴压力性尿失禁（SUI）患者的尿道参数，探讨影响膀胱膨出患者SUI的因素。
方法：评估的二维参数包括阴道旁缺损，肛提肌缺陷,尿道长度,尿道漏斗形,膀胱颈漏斗宽度，膀胱颈漏斗深度，尿道角度,后膀胱尿道角，和膀胱前突。三维参数包括近端尿道旋转角度，远端尿道旋转角度，膀胱颈部活动能力,尿道中点活动，和尿道外道活动。连续变量采用独立样本t检验，分类变量采用卡方检验。采用二元logistic回归分析确定与膀胱膨出患者SUI独立相关的因素。
结果：两组的基线参数相似。伴有SUI的囊肿患者的Aa点明显较高（1.63±1.06cmvs.0.81±1.51cm,p=0.008）；膀胱前突更多（33.3%vs.11.4%,p=0.017）；膀胱颈活动度更大（36.38±11.46mmvs.28.81±11.72mm,p=0.005);尿道中部活动度(22.94±6.50mmvs.19.23±6.65mm,p=0.014）；和尿道外道活动度（22.42±8.16mmvs.18.03±8.51mm,p=0.022）比没有SUI的膀胱膨出患者高。各组其他尿道参数相似(p>0.05)。二元logistic回归分析显示，膀胱颈活动度与女性的SUI独立相关（优势比，1.06；95%CI1.015-1.107；p=0.009）。
结论：患有SUI的膀胱膨出患者Aa较高，更多的前膀胱突出，与没有SUI的人相比，尿道流动性更大。膀胱颈部活动度与女性的SUI独立相关。
背景：NCT03146195。
方法：评估的二维参数包括阴道旁缺损，肛提肌缺陷,尿道长度,尿道漏斗形,膀胱颈漏斗宽度，膀胱颈漏斗深度，尿道角度,后膀胱尿道角，和膀胱前突。三维参数包括近端尿道旋转角度，远端尿道旋转角度，膀胱颈部活动能力,尿道中点活动，和尿道外道活动。连续变量采用独立样本t检验，分类变量采用卡方检验。采用二元logistic回归分析确定与膀胱膨出患者SUI独立相关的因素。
结果：两组的基线参数相似。伴有SUI的囊肿患者的Aa点明显较高（1.63±1.06cmvs.0.81±1.51cm,p=0.008）；膀胱前突更多（33.3%vs.11.4%,p=0.017）；膀胱颈活动度更大（36.38±11.46mmvs.28.81±11.72mm,p=0.005);尿道中部活动度(22.94±6.50mmvs.19.23±6.65mm,p=0.014）；和尿道外道活动度（22.42±8.16mmvs.18.03±8.51mm,p=0.022）比没有SUI的膀胱膨出患者高。各组其他尿道参数相似(p>0.05)。二元logistic回归分析显示，膀胱颈活动度与女性的SUI独立相关（优势比，1.06；95%CI1.015-1.107；p=0.009）。
结论：患有SUI的膀胱膨出患者Aa较高，更多的前膀胱突出，与没有SUI的人相比，尿道流动性更大。膀胱颈部活动度与女性的SUI独立相关。
背景：NCT03146195。
