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Background and Purpose: In recent years, Chinese women due to the uterine fibroids Adenomyoma, functional diseases of the uterus and benign lesions upward trend line surgery, hysterectomy is the most common surgical procedure for the treatment of uterine disease. Reproductive Medicine and Neuroendocrinology research progress, more and more clinical studies have shown: hysterectomy is not only an impact on ovarian function, hormone and metabolite levels, the impact of the bladder and pelvic floor function can not be ignored. . Urodynamic (urodynamics UDS) in accordance with the basic principles and methods of fluid mechanics and electrophysiology, urinary tract symptoms in patients with maps and digital performance, provide an objective basis for the clinical development of proper treatment programs and assessment of disease outcome. The Urodynamic by urinary flow rate, pressure on the bladder, urethral pressure measurement (UPP), including maximum urethral closure pressure (MUCP), functional urethral length (FUL), the area under the curve and EMG parameter analysis, preliminary judgment under the function of the urethra. Ultrasound imaging (ultrasonography, us) for morphological examination can clearly show the position of the bladder neck and bladder wall thickness. In order to deepen the understanding of lower urinary tract function in different surgical hysterectomy, the research by means of ultrasound urodynamic study technology, from October 2007 to October 2008 in Hebei Province People's Hospital gynecological benign disease of the uterus to accept traditional hysterectomy and triangle hysterectomy in patients with preoperative and postoperative functional assessment of the bladder and urethra, in order to investigate the clinical value of triangle hysterectomy, surgical procedures to provide appropriate clinical choice. Materials and Methods: Study subjects: Select from October 2007 to October 2008 in Hebei Province People's Hospital gynecological hospital surgical treatment for benign uterine disease patients 60 patients were randomly divided into two groups, line triangle hysterectomy 30 cases for the experimental group, 20 cases of uterine fibroids, Adenomyosis 10 cases. Line hysterectomy 30 patients in the control group. 18 cases of uterine fibroids, Adenomyosis 12 cases. (Two groups of patients age, occupation general there was no significant difference; reserves the bilateral annex). All patients underwent complete preoperative and postoperative ultrasound urodynamic follow-up, the mean follow-up time after surgery was 30 ± 3 days. 2 urodynamic check instrument: using MMS Solar urodynamic examination instrument, all patients in the preoperative, postoperative five days, one month after complete urodynamic study, carried out in accordance with the provisions of the International Continence Society. Determination of content including free urinary flow rate, bladder pressure flow rate / pressure-volume measurement, static urethral pressure measurement. 3 ultrasonic diagnostic apparatus: the GE Company Voluson730Pro ultrasonic diagnostic apparatus, urethral pressure measurement perineal vestibular B-measurement quiescent bladder filling 200 ml bladder wall thickness and bladder neck position. 4 using SPSS 10.0 statistical software for statistical analysis, count data using the chi-square test; measurement data, the parameters of the results were expressed as mean ± standard deviation (x ± s), multiple sets of data using analysis of variance (ANOVA), and homogeneity of variance test; to further q test for pairwise comparison analysis of variance significant difference. When the heterogeneity of variance, using the non-parametric rank test. Test level to take alpha = 0.05, when P lt; 0.05 when statistically significant. Results: 1 hysterectomy patients after lower urinary tract symptoms usually presents with urinary frequency, urinary urgency, urinary incontinence, urinary endless sense of urination wait. After 5 days in the control group, the abnormal symptoms significantly more than the experimental group were significantly different (P lt; 0.05). One month after abnormal number of cases of the two groups were significantly reduced, but the two groups there is still a significant difference (P lt; 0.05). Hysterectomy urinary flow curve anomaly appears: delayed peak, the curve flat peak, intermittent urination curve. Free urine flow results show that: the two groups before the free determination of urine flow was not statistically significant. After 5 days, the maximum flow rate of the control group, the average flow rate compared to preoperative decreased, there is a significant difference (P lt; 0.05) compared with the preoperative urine output to reduce urine flow, post-void residual than before surgery, compared to an increase, but there was no statistically significant difference (P gt; 0.05). Experimental group decreased maximum flow rate with preoperative significant difference (P lt; 0.05), average flow rate decreased compared with before surgery, but no significant difference (P GT; 0.05), urine output, post-voiding residual urine volume compared with preoperative no significant change was not statistically significant. Maximum urinary flow rate, average flow rate of the control group than the experimental group had significant changes (P lt; 0.05) One month after two sets of abnormal results were significantly reduced, but the two sets of maximum urinary flow rate, there is still a significant difference (P lt; 0.05). 3 hysterectomy bladder anomaly appears: the detrusor muscle fiber contraction decreased, over-sensitive bladder sensation, bladder function test results showed that: the two groups before bladder function test was not statistically significant. After 5 days, compared to the control group, maximum detrusor pressure, bladder compliance compared with the preoperative and the experimental group decreased significantly, a statistically significant difference (P lt; 0.05), no significant change in maximum bladder capacity compared with the preoperative and experimental group normal to urinate bladder capacity compared with the preoperative and the experimental group decreased, but the differences were not statistically significant (P GT; 0.05) There were significant differences (P lt; 0.05), compared to the experimental group after 5 days maximum detrusor pressure and bladder compliance with preoperative I measurement results were not statistically different. One month after two sets of bladder function were improved, but the control group and the experimental group, the maximum detrusor pressure measurement results are still significant differences (P lt; 0.05) 4 before and after surgery, urethral pressure measurement results show: the traditional hysterectomy the postoperative functional urethral length and triangle hysterectomy compared shorten, but statistically the difference was not significant (P GT; 0.05), maximum urethral pressure and maximum urethral closure pressure before and after surgery showed no significant change (P gt; 0.05) Two surgical hysterectomy, bladder wall thickness compared with the preoperative was no significant difference (P gt; 0.05). Quiescent perineum from the to said bladder neck position of the bladder neck, suggesting that before and after surgery, bladder neck is not obvious displacement (P gt; 0.05) statistical analysis meaningless. Conclusion: 1 hysterectomy have an adverse effect on bladder function. 2 uterus resection of bladder dysfunction urodynamic characteristics of bladder detrusor muscle fiber contraction to reduce noncompliance. The hysterectomy triangle hysterectomy after lower urinary tract symptoms, urinary flow rate, urodynamic varying degrees of change, but both there is still a significant difference, the triangle hysterectomy The surgery bladder function significantly less than traditional hysterectomy. 4 free urine flow is simple and safe, easy, non-invasive can detect abnormal urination as hysterectomy screening method.
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