긴장성 요실금 환자의 회음부 초음파 검사에 있어서 앙와위와 직립위의 비교

Abstract

PURPOSE : To assess whether there would be a discrepancy in perineal sonography performed in the supine and standing position in the evaluation of stress urinary incontinence. MATERIALS AND METHODS : Ultrasonography was performed to 42 female patients with stress urinary incontinence. Sagittal images through the bladder, urethrovesical junction and urethra were obtained from the perineal area. The posterior urethrovesical angle (PUVA) and the distance of bladder neck descent were measured at rest and during Valsalva's maneuver in both supine and standing position. The difference of the values obtained in the supine and standing position was statistically evaluated by paired t-test. The number of positive results was also compared between the two positions. RESULTS : In the supine position, mean value of PUVA was 121.8°±18.5(standard deviation) at rest, 145.5°±27.7 during Valsalva's maneuver, and the difference was 23.7 °±24.4. The distance of bladder neck descent was 10.7mm°±6.0. In the standing position, mean PUVA was 132.9°±19.3 at rest, 159.7°±29.2 during Valsalva's maneuver, and the difference(△PUVA) was 26.8°±21.2. The distance of bladder neck descent was 10.4mm°±6.1. Both values of the PUVA obtained at rest and during Valsalva's maneuver in the standing position were higher than the value obtained in the supine position(p<0.001, respectively), but the △PUVA was not significantly different between in the supine and in the standing position(p>0.1). However, the numbers of cases showing positive results were increased from 27 cases on supine position to 37 cases on standing position. CONCLUSION : PUVA and △PUVA can be significantly different on changing position, but BND is not affected by changing position. Examination in the standing position can increase the positive result of the diagnosis of SUI.