女性压力性尿失禁的解剖学发病机制探讨

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Anatomical pathogenesis of female stress urinary incontinence

SHEN Jihong，LI Ling

（Department of Urology，The First Affiliated Hospital of Kunming Medical University，Kunming 650032，China）

ABSTRACT：Urinary control in females is a complex physiological process.From an anatomical perspective，this article explores the role of static urethral anatomical changes and dynamic functional anatomical changes in the occurrence of female stress urinary incontinence （SUI）.In SUI patients，the changes in the urethra include mucosal atrophy，reduced elasticity，sphincter dysfunction，and shortening of the functional urethral length.The surrounding supportive structures involved in the development of SUI include weakened bladder neck support，damage to the hammock structure，weakened pubic urethral ligament and dysfunction of the levator ani muscle.Additionally，damage to the pelvic floor nerve plays an important role in the pathophysiology of SUI.In terms of dynamic functional anatomy，this article analyzes three dynamic interlocking mechanisms，including the interlock between the bladder neck and pelvic diaphragm，the external urethral sphincter and levator ani muscle，the posterior urethra and perineal body.Through these dynamic mechanisms，the static structure is coordinated and supported，helping to maintain normal urinary control function.These analyses aid in understanding the mechanisms underlying urinary control problems in SUI patients.In summary，this article attempts to construct a clear theoretical framework for the clinical diagnosis and treatment of female SUI by systematically analyzing the static and dynamic factors of female urinary control mechanisms.

KEY WORDS：functional anatomy；female stress urinary incontinence；bladder neck and pelvic diaphragm interlock；external urethral sphincter and levator ani muscle interlock；posterior urethra and perineal body interlock；pathogenesis

摘要：女性控尿是一个复杂的生理过程，本文从解剖学层面分析静态的尿道解剖结构改变和动态的功能解剖学变化因素在女性压力性尿失禁（SUI）发生中的作用。（剩余17496字）