Burrows Lara J, Meyn Leslie A, Walters Mark D, Weber Anne M
Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Women's Hospital, Pittsburgh, Pennsylvania 15213, USA.
Obstet Gynecol. 2004 Nov;104(5 Pt 1):982-8. doi: 10.1097/01.AOG.0000142708.61298.be.
To assess symptoms of bladder, bowel, and sexual function in women with pelvic organ prolapse and to compare symptoms by different degrees of prolapse.
This retrospective study used data from 352 women with prolapse or urinary incontinence. The pelvic organ prolapse quantification measurements, as well as responses to 3 self-administered questionnaires assessing urinary, bowel, and sexual function were used. For each individual, pelvic organ prolapse quantification measures of prolapse were obtained in centimeters in relation to the hymen for 3 compartments: anterior vagina, vaginal apex or cervix, and posterior vagina. Data were analyzed by comparing the frequency of symptoms to centimeter measures of the most advanced prolapse (regardless of site) and the other compartments of prolapse.
Of the 330 patients available for analysis, 2.4% had stage I, 46.1% had stage II, 48.2% had stage III, and 3.3% had stage IV prolapse. The average age was 58.8 years (+/- 12.1), with a median parity of 3. Forty-eight percent were postmenopausal and taking estrogen, 27% were postmenopausal and not taking estrogen, and 25% were premenopausal. Patients who had stress incontinence symptoms had less advanced prolapse (median 5 cm less prolapse in the apical compartment) than patients without stress incontinence. Women who required manual assistance to urinate had more advanced prolapse (median 3.5 cm more prolapse in the most advanced compartment) than those who did not. Patients with urinary urgency and urge incontinence also had less advanced prolapse, although the differences were smaller than for stress incontinence (median 3 cm difference or less). There were no clinically significant differences in any compartment for symptoms related to sexual or bowel function.
Women with more advanced prolapse were less likely to have stress incontinence and more likely to manually reduce prolapse to void; however, prolapse severity was not associated with sexual or bowel symptoms.
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评估盆腔器官脱垂女性的膀胱、肠道及性功能症状，并比较不同脱垂程度的症状。
这项回顾性研究使用了352名患有脱垂或尿失禁女性的数据。采用盆腔器官脱垂定量测量以及3份自我管理问卷对泌尿、肠道和性功能的回答。对于每个个体，针对3个腔室（前阴道、阴道顶端或宫颈、后阴道）获取相对于处女膜的脱垂盆腔器官脱垂定量测量值，以厘米为单位。通过比较症状频率与最严重脱垂（无论部位）及其他脱垂腔室的厘米测量值来分析数据。
在可供分析的330例患者中，2.4%为I期，46.1%为II期，48.2%为III期，3.3%为IV期脱垂。平均年龄为58.8岁（±12.1），中位产次为3次。48%为绝经后且服用雌激素，27%为绝经后且未服用雌激素，25%为绝经前。有压力性尿失禁症状的患者脱垂程度较轻（顶端腔室脱垂中位数少5厘米），比无压力性尿失禁的患者轻。需要手动辅助排尿的女性脱垂程度更严重（最严重腔室脱垂中位数多3.5厘米），比不需要手动辅助排尿的女性严重。有尿急和急迫性尿失禁的患者脱垂程度也较轻，尽管差异比压力性尿失禁小（中位数差异为3厘米或更小）。在与性或肠道功能相关的症状方面，任何腔室均无临床显著差异。
脱垂程度更严重的女性压力性尿失禁的可能性较小，更有可能手动还纳脱垂以排尿；然而，脱垂严重程度与性或肠道症状无关。
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