压力性尿失禁的诊断.pptVIP

妇科泌尿学 Urogynecology;Urogynecology;妇科泌尿学主要研究内容;;概况;;盆底解剖新概念-四个“三”;anterior: 膀胱及阴道前壁 Middle： 子宫及阴道穹隆 Posterior：阴道后壁及直肠;盆底解剖新概念-3 Ligaments: ;盆底解剖新概念-3 Muscles; 第一部分 压力性尿失禁;SUI类型;SUI的原因;发病机理 ;发病机理;SUI的诊断标准;SUI分度-Ingelman-Sundberg;SUI诊断步骤;SUI病史;泌尿外科检查;诱发试验;尿道抬举试验（指压试验）;尿道长度测定;膀胱镜检查;棉签试验（Q-Tip）试验;腹直肌分离试验 ;尿流动力学测定 -女性膀胱功能正常值;尿流动力学测定 -女性膀胱功能正常值;妇科检查;神经系统;鉴别诊断;SUI和UUI鉴别诊断;No single surgery is the answer for all patients ; 治疗原则;Description :Dr. Arnold Kegel 1948 Definition: Kegel exercises are a series of pelvic muscle exercises designed to strengthen the muscles of the pelvic floor.; Principle Strengthen the muscles of the pelvic floor Improving the urethral and rectal sphincter function The success of Kegel exercises Depends on proper technique adherence to a regular exercise; Begin by emptying your bladder. Tighten the pelvic floor muscles 1-5sec. Relax the muscle completely for 1-5sec. Perform 10 exercises (5min), three times a day 4 to 6 weeks: most people notice improvement. 3 months:a significant change.;LET US TRY!!!;Some people: difficulty identifying and isolating the muscles of the pelvic floor. Most people: contract the abdominal or thigh muscles. These incorrect contractions may even worsen pelvic floor tone and incontinence.;Stop the flow of urine midstream Finger marker Biofeedback: positive reinforcement Electrical stimulation;Speed up the progress by increasing the number of repetitions and the frequency of exercises. Over-exercising:muscle fatigue and increase leakage of urine.;Surgery of SUI; TVT （Tension free vaginal tape) ;; IVS(intravaginal sling);MONARC-经闭孔尿道下段悬吊术;John Burch introduced the Burch colposuspension in 1961; 第二部分 盆腔器官脱垂(POP);POP手术治疗新观念;整体理论（Integral Theory）;六种解剖学缺陷?;三种独立的关闭机制; POP定量系统 Baden-Walker提出的POP阴道半程系统分级法（Halfway System）。 Bump提出盆腔器官脱垂定量分期??（Pelvic Organ Prolaps Quantitation，POP-Q）。 前一种方法简便易行，后一种方法客观、准确，并在国际上50%的文献中得到应用。 ;POP量化分期--Baden-Walker阴道半程系统分级法（halfway);PO