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首页> 外文期刊>The journal of sexual medicine >Female urinary incontinence at orgasm: a possible marker of a more severe form of detrusor overactivity. Can ultrasound measurement of bladder wall thickness explain it?
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Female urinary incontinence at orgasm: a possible marker of a more severe form of detrusor overactivity. Can ultrasound measurement of bladder wall thickness explain it?

机译：高潮时女性尿失禁：逼尿肌过度活动更为严重的可能标志。超声测量膀胱壁厚可以解释吗？

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INTRODUCTION: Coital incontinence (CI) during orgasm is a form of urinary incontinence possibly because of detrusor overactivity (DO), as the underlying pathophysiological condition. Women with this symptom usually show a pharmacological lower cure rate than those with DO alone. The ultrasound measurement of the bladder wall thickness (BWT) allows an indirect evaluation of detrusor muscle thickness, giving a potential index of detrusor activity. AIM: We wanted to understand if CI at orgasm could be a marker of severity of DO by comparing BWT in women with both DO and CI at orgasm vs. women with DO alone. In addition we aimed to confirm if CI during orgasm is related to antimuscarinics treatment failure. METHODS: This is a prospective cohort study performed in two tertiary urogynecological referral departments, recruiting consecutive patients seeking treatment for symptomatic DO. MAIN OUTCOME MEASURES: All patients were thoroughly assessed including physical examination, urodynamic evaluation, and BWT measurement according to the International Continence Society/International Urogynecological Association and ICI recommendations. Solifenacine 5 mg once daily was then prescribed and follow-up was scheduled to evaluate treatment. Multiple logistic regression (MLR) was performed to identify risk factors for treatment failure. RESULTS: Between September 2007 and March 2010, 31 (22.6%) and 106 (77.4%) women with DO with and without CI at orgasm were enrolled. Women complaining of CI at orgasm had significantly higher BWT than the control group (5.8 +/- 0.6 mm vs. 5.2 +/- 1.2 mm [P=0.007]). In patients with CI at orgasm, the nonresponder rate to antimuscarinics was significantly higher than controls (P=0.01). After MLR, CI at orgasm was the only independent predictor decreasing antimuscarinics efficacy (odds ratio [OR] 3.16 [95% CI 1.22-8.18], P=0.02). CONCLUSIONS: Women with DO and CI at orgasm showed a significantly higher BWT values and worse cure rates than women with DO alone. CI at orgasm could be a marker of a more severe form of DO.
机译：简介：性高潮时的尿失禁是尿失禁的一种形式，可能是由于逼尿肌过度活动（DO）作为潜在的病理生理状况。患有这种症状的女性通常比单独使用DO的女性具有更低的药理学治愈率。膀胱壁厚度（BWT）的超声测量可以间接评估逼尿肌的厚度，从而给出逼尿肌活动的潜在指标。目的：我们想通过比较同时有DO和高潮时CI的女性的BWT和仅有DO的女性来了解高潮时CI是否可以作为DO严重程度的标志。此外，我们旨在确认性高潮期间的CI是否与抗毒蕈碱药物治疗失败有关。方法：这是在两个三级泌尿妇科转诊部门进行的前瞻性队列研究，招募了连续寻求对症溶解氧治疗的患者。主要观察指标：所有患者均经过全面评估，包括体格检查，尿流动力学评估和BWT测量，均符合国际节制学会/国际妇产科协会和ICI的建议。然后开出每天一次的5 mg Solifenacine处方，并安排随访评估治疗情况。进行多元逻辑回归（MLR）以确定治疗失败的危险因素。结果：在2007年9月至2010年3月之间，招募了31名（22.6％）和106名（77.4％）的高潮期有或没有CI的妇女。在性高潮时抱怨CI的女性的BWT明显高于对照组（5.8 +/- 0.6毫米vs. 5.2 +/- 1.2毫米[P = 0.007]）。高潮期CI患者对毒蕈碱类药物的无反应率显着高于对照组（P = 0.01）。在MLR之后，高潮时的CI是唯一降低抗毒蕈碱功效的独立预测因子（赔率[OR] 3.16 [95％CI 1.22-8.18]，P = 0.02）。结论：高潮时DO和CI的女性比单纯DO的女性表现出更高的BWT值和更差的治愈率。高潮时的CI可能是更严重的DO的标志。

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