[Evaluation of urinary tract function in various types of urinary incontinence in women].
164 women from 18 to 74 years of age (mean 48.3) with urinary incontinence, previously not operated, with out any neurogenic symptoms, with sterile urine were studied. The kind of incontinence was estimated on the basis of clinical history and examination, the analysis of frequency/volume charts, free uroflowmetry and cystometry in sitting and standing positions. Genuine stress incontinence (GSI) was recognized in 121 (73.8%) women, urge incontinence (UI) in 15 (9.1%), and mixed incontinence (MI) in remaining 28 (17.1%) women. Women with UI and MI had significantly more often both daytime (12.5 +/- 6.4 and 10.3 +/- 2.5), and night-time mictions, comparing to GSI (7.2 +/- 2.8) with simultaneously smaller daytime voided volumes (91 +/- 36.0 ml and 125 +/- 50.0 ml) comparing to GSI (175 +/- 151 ml). Mean voided volume and Qmax in free uroflowmetry were significantly greater in GSI (293 +/- 124 ml, 24.6 +/- 8.4 ml/s comparing to 165 +/- 69.0 ml, 17.0 +/- 7.8 ml/s in UI). The bladders of women with UI showed motoric and sensoric hyperactivity, uninhibited detrusor contractions, decreased CysCapmax, higher PdetCysCapmax, and decreased compliance. Mean CysCapmax was 240 +/- 102 ml, with first sensation after filling mean 145 +/- 90.1 ml, with Pdet 29.3 +/- 13.4 cm H2O, and compliance 13.2 +/- 7.7 ml/cm H2O. In women with both GSI and MI the values were significantly higher and were respectively, for CysCapmax 455 +/- 148 ml, 308 +/- 58 ml, for VFD 237 +/- 76 ml and 169 +/- 25 ml, PdetCysCapmax 12.9 +/- 5.4 cm H2O and 16.5 +/- 4.9 cm H2O, and for C 41.7 +/- 20.5 ml/cm H2O and 28.2 +/- 8.1 ml/cm H2O. The urge syndrome accompanied by urine incontinence, decreased functional bladder capacity evaluated from frequency/volume charts and free uroflowmetry are the indications for performing cystometry with simultaneous monitoring of abdominal pressure. It allows to recognize urge and mixed incontinence.
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I Katedry i Oddziału Klinicznego Urologii Slaskiej Akademii Medycznej w Katowicach.
D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D011187:Posture; D001745:Urinary Bladder Diseases / Q000175:diagnosis / Q000503:physiopathology; D014549:Urinary Incontinence / Q000145:classification* / Q000503:physiopathology*; D014550:Urinary Incontinence, Stress / Q000175:diagnosis / Q000503:physiopathology; D014563:Urodynamics