علاقة عمل المثانة و الإحليل خلال تخطيط المثانة مع الموجودات السريرية و جريان البول الحر لدى مريضات سلس البول

الملخص EN

Objective : To investigate the relationship between function of bladder and urethra during cystometry and both clinical findings and free uroflow in women with urinary incontinence.

Methods : One hundred forty one women with urinary incontinence who underwent free uroflow (without catheter) and cystometry, between 1 May 2007 till 1 May 2016 were enrolled in the study.

Exclusion criteria included those who couldn’t urinate without catheter on uroflow chair, pregnant women and women with untreated urinary infection.

Results : Women in the study were 47±9 years old, pure urge incontinence consisted 19.9% of cases, whereas pure stress type formed 12.1% of cases and mixed type consisted 68.4%.

Also dysuria was seen in 15.6% of women in the study.

Concerning uroflowmetry, shapes and parameters of uroflow were classified into three types; excellent type (33.3% of cases), good type (41.2% of cases), and bad one (25.5%), according to its’ shapes and its’ relationship with Liverpool normograms for maximum and average flow rates.

On the other hand, the functions of urethra and bladder were classified according to PdetQmax in cystometry and free uroflow Qmax into three groups; normal bladder and urethral function (64.5% of cases), obstruction in urethra (19.1% of cases) and underactive bladder (16.3% of cases).

Concerning underactive bladder it was significantly more prevalent in cases of pure stress incontinence, presence of cystocyle, positive stress test, story of dysuria, and presence of urodynamic stress incontinence in cystometry.

Whereas obstruction was significantly more prevalent in cases of pure urge incontinence and presence of overactive bladder in cystometry.

Excellent type of uroflow had low sensitivity (45.05%) and high specificity (88%) in predicting normal bladder and urethral function.

Whereas bad type had also low sensitivity (50%) and high specificity (87.9%) but in predicting dysfunctional voiding.

Conclusions: Underactive bladder is more frequently seen in cases of pure stress incontinence, cystocyles, positive stress test, story of dysuria and urodynamic stress incontinence, whereas obstruction is more prevalent in cases of pure urge incontinence and overactive bladder.

Concerning excellent type of uroflow (which had bell shape with maximum flow rate in the first third of flow, Qmax ≥2 Qave, Qmax ≥30% and Qave ≥10% according to Liverpool normograms), it had low sensitivity (45.05%) and high specificity (87.9%) in predicting normal bladder and urethral function.