2. 환자군에서는 방광 경부 하강은 18.96±4.42mm, 21.15±4.89mm이며 개구는 3.63±0,82mm, 4.21±0.93mm로 두 검사 방법 간에 좋은 상관관계를 가지고 있다.(정부 하강 : r=0.76, P=O.0000, 경부 개구 ; r=0.78 P=0.0000)
3. 방광경감하강은 12.2mm, 개구틀 1.52mm로 회음부초음파의 진단기준을 정했을 때 하강은 민감성 95%, 특이성 100%이며 개구는 민감성, 특이성 모두 100%이었다.
회음부 초음파 검사법은 탐촉자를 외음부에 부착하여 검사하는 방법으로 비침습적이며 간편하고 방광 경부의 이동에 탐촉자에 의한 방해를 주지 않고 하강 상태를 지속적으로 관찰함으로 진성 요실금과 주위 장기에 의한 이차적 요실금을 감별할 수 있으며 방광- 요도 도자술 등의 방사선학적 검사를 대치할 수 있는 유용한 검사법이다.
Signiflcance of perineal ultrasonography In diagnosing genuine stress Incontinence
Kyung Sang Lee
Department of Medical Science The Graduate School, Yonsei University
(Directed by Associate Prefessor Hyung Sik Yoo)
The aim of this study is to determine the effectiveness of perineal
ultrasonography compared with transrectal ultrasonography in the diagnosis of
genuine stress incontinence.
Twenty normal woman and forty women with genuine stress incontinence were
included in this study.
Diagnostic procedures included one-hour pad test urodynamic study and
cystourethroscopy.
Both transrectal approach using 5MHz transrectal probe(ATL UM9) and perineal
approach using 3.5MHz convex probe(GE RT 4600) were performed in all candidates in
left lateral decubitus arts lithotomy position.
The bladder volume at the time of investigation varied from 100-300mL. The degree
of bladder neck descent and bladder neck opening during Valsalva maneuvers were
compared between two procedures.
The results were as follow :
1. In normal control group, the mean bladder neck descent and the opening using
transrectal and perineal approach were 7.90±1.86/8.30±1.95mm,
0.36±0.50/0.40±0.57mm (P=0.0000), respectively.
2. Diagnostic criteria of genuine stress incontinence with peruineal
ultrasonography were suggested 12.2mm descent of bladder neck(sensitivity=95%,
speciflcity=100%) and 1.52mm opening of bladder neck(sensitivity=100%, speciflcity=
100%), respectively.
3. In genuine stress incontinence group, the mean bladder neck descent and
opening using transrectal and perineal ultrasonography were
Perineal measurement were significantly greater than transrectal measurements.
4. There was a good correlation between the measurements of perineal and
transrectal approach(r=0.76 in bladder neck descent, r=0.78 in opening)
The advantages of perineal ultrasonography are simple, nun-invasive, readily
accesible and less stressful to the patients, and it is devoid of bladder neck
artifact during Valsalva without mechanical hinderance.
Therefore, the perineal ultrasonography can replace ultrasonography and recommend
in diagnosing genuine stress incontinence.
[영문]
The aim of this study is to determine the effectiveness of perineal ultrasonography compared with transrectal ultrasonography in the diagnosis of genuine stress incontinence.
Twenty normal woman and forty women with genuine stress incontinence were included in this study.
Diagnostic procedures included one-hour pad test urodynamic study and cystourethroscopy.
Both transrectal approach using 5MHz transrectal probe(ATL UM9) and perineal approach using 3.5MHz convex probe(GE RT 4600) were performed in all candidates in left lateral decubitus arts lithotomy position.
The bladder volume at the time of investigation varied from 100-300mL. The degree of bladder neck descent and bladder neck opening during Valsalva maneuvers were compared between two procedures.
The results were as follow :
1. In normal control group, the mean bladder neck descent and the opening using transrectal and perineal approach were 7.90±1.86/8.30±1.95mm, 0.36±0.50/0.40±0.57mm (P=0.0000), respectively.
2. Diagnostic criteria of genuine stress incontinence with peruineal ultrasonography were suggested 12.2mm descent of bladder neck(sensitivity=95%, speciflcity=100%) and 1.52mm opening of bladder neck(sensitivity=100%, speciflcity= 100%), respectively.
3. In genuine stress incontinence group, the mean bladder neck descent and opening using transrectal and perineal ultrasonography were 18.98±4.42/21.15±4.89mm, 3.63±0.82/4.21±O.93mm (p=0.0000), respectively.
Perineal measurement were significantly greater than transrectal measurements.
4. There was a good correlation between the measurements of perineal and transrectal approach(r=0.76 in bladder neck descent, r=0.78 in opening)
The advantages of perineal ultrasonography are simple, nun-invasive, readily accesible and less stressful to the patients, and it is devoid of bladder neck artifact during Valsalva without mechanical hinderance.
Therefore, the perineal ultrasonography can replace ultrasonography and recommend in diagnosing genuine stress incontinence.