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KMID : 0358419930360040503
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Korean Journal of Obstetrics and Gynecology
1993 Volume.36 No. 4 p.503 ~ p.520
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A Study of the Anatomic Configuration of Bladder and Urethra in Patients with Stress Urinary Incontience Before and After Anterior Colporrhaphy -Analysis with metallic beaded chain urethrocystogrphy-
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Abstract
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This present study was undertaken to evaluate the characteristic anatomic configuration of bladder and urethra in patients with stress urinary incontinence before and after anterior colporrhaphy and the efficacy of this operation as a corrective
surgery
for anatomic changes.
For these purposes, metallic beaded chain urethrocystography was conducted in 42 patients with stress urinary incontinence before and after anterior colporrhaphy and 10 normal continent control at Department of Obstetrics and Gynecology,
Chung-Ang
University Hospital from March 1986 to September 1989.
@ES The results were as follows:
@EN The height and depth of bladder were significantly increased in patients with stress urinary incontinence compared with normal control but not the width.
Posterior urethrovesical angle and urethral inclination angle on straining were greater and posterior urethrovesical junction was lower in stress urinary incontinence than in normal continence. Stress urinary incontinent patients with abnormal
urethral
axis(Type II) showed significantly greter posterior urethrovesical and urethral inclination angles land lower posterior urethrovesical junction than in patients with normal axis (Type I). After anterior colporrhaphy, posterior urethrovesical and
urethral inclination angles were significantly smaller and posterior urethrovesical junction was significantly elevated than before operation But loss of posterior urethrovesical angle was not corrected in 38.1% of all patient with stress urinary
incontinence and posterior urethrovesical junction was still placed below the SSv line in 57.1%. Most of the II patients, especially, showed this findings.
From these results, we concluded that stress urinary incontinence is the results of anatomically defective supports of urethrovesical junction and stress urinary incontinence with abnormal urethral axis suggests more severe defective anatomic
supports.
Anterior colporraphy is not considered as a proper surgical method for stress urinary incontinence based on anatomical views because this procedure doesn't satisfactorily correct abnormal urethrovesical anatomic configurations.
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