浙江医学2025，Vol.47Issue(22)：2404-2408,5.DOI:10.12056/j.issn.1006-2785.2025.47.22.2025-1595
经会阴盆底超声检查在女性膀胱颈梗阻诊断中的应用
Application of transperineal pelvic floor ultrasound in the diagnosis of female bladder neck obstruction
摘要
Abstract
Objective To explore the application of transperineal pelvic floor ultrasound(TPUS)in the diagnosis of female bladder neck obstruction(FBNO).Methods A total of 126 female patients who visited Jinhua Hospital,Zhejiang University School of Medicine,from May 2020 to January 2025 were retrospectively enrolled.According to the urodynamic findings,patients were divided into three groups:a non-FBNO group(n=30,without FBNO and with normal urinalysis,having urinary diseases other than FBNO),an FBNO group(n=73),and an FBNO+urinary retention group(n=23,residual urine ≥50 mL).The urodynamic and TPUS parameters among the three groups were compared,and multivariate logistic regression analysis was performed to explore the relationships between urodynamic and TPUS parameters and FBNO.Results Compared with the non-FBNO group,both the FBNO+urinary retention group and the FBNO group showed significantly reduced maximum urinary flow rate(Qmax)(all P＜0.05),while the maximum detrusor pressure,detrusor pressure at the beginning of voiding,and detrusor pressure at the end of voiding were all significantly increased(all P＜0.05).The bladder neck height,urethral inclination angle,bladder neck mobility,and urethral rotation angle during the Valsalva states,as well as posterior urethrovesical angles in both resting and Valsalva states were all significantly smaller(all P＜0.05);the thicknesses of the anterior and posterior lips of the bladder neck were significantly increased(both P＜0.05),and the incidence of bladder neck funneling was markedly reduced(P＜0.016 7).Qmax(OR=0.47),maximum detrusor pressure(OR=1.21),detrusor pressure at the beginning of voiding(OR=1.13),detrusor pressure at the end of voiding(OR=1.10),posterior urethrovesical angle at rest(OR=0.97),posterior urethrovesical angle during Valsalva state(OR=0.97),urethral inclination angle during Valsalva state(OR=0.98),urethral rotation angle during Valsalva state(OR=0.97),thickness of the anterior bladder neck lip(OR=20.34),thickness of the posterior bladder neck lip(OR=20.34),and bladder neck funneling(OR=0.07)were all related to the onset of FBNO(all P＜0.05).Conclusion TPUS can comprehensively evaluate voiding structural abnormalities in FBNO patients,and when combined with urodynamic testing,it provides valuable complementary diagnostic effect.关键词
经会阴盆底超声/膀胱颈梗阻/女性/尿动力学Key words
Transperineal pelvic floor ultrasound/Bladder neck obstruction/Female/Urodynamics引用本文复制引用
赵昶沣,楼叶琳,祝舒旭,吴汉,胡洋..经会阴盆底超声检查在女性膀胱颈梗阻诊断中的应用[J].浙江医学,2025,47(22):2404-2408,5.基金项目
浙江省医药卫生科技计划项目(2025KY1747) （2025KY1747）
金华市科技计划项目(2022-3-085) （2022-3-085）
