전질벽 탈출증 환자에서 병기와 연령에 따른 최대요도폐쇄압과 기능적 요도길와의 연관성

Abstract

Objective : MUCP (Maximal urethral closing pressure) was known to be increase in vaginal wall prolapse patients due to mechanical obstruction of urethra. However, urethral function following reduction has not been completely evaluated. Prediction of postoperative urethral function may give additional information in counseling prior to surgery. Thus this study was performed to evaluate the relationship between MUCP, functional urethral length(FUL) according to stage, age in anterior vaginal wall prolapse patients. Methods : 139 patients diagnosed of pelvic organ prolapse (POP) at YUMC from March 1999 to May 2003, and had underwent urethral pressure profilometry following reduction were included in this study. The stage of POP was determined according to the dependent portion on anterior vaginal wall (Aa, Ba). (By International Continence Society's POP Quantification system) Results : Patients were divided in age groups of 40s, 50s, 60s, above 70s, and each group included 13, 53, 54 and 16 patients. No difference in MUCP was found between the groups. FUL of 40s was shorter than that of 50s, 60s. Patients were divided in stage Ⅱ,Ⅲ,Ⅴ and each group included 35,76 and 25 patients. No significant difference in MUCP was found according to stage, regarding FUL, significant difference was noted between stage Ⅲ and Ⅳ groups, that of stage Ⅳ longer. Conclusion : Anterior vaginal wall prolapse was known to affect urethral function due to prolapse itself, but according to our study, prolapse itself did not alter urethral function suggesting that prolapse corrective surgery does not effect the urethral function regardless of stage, age.