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Burch阴道悬吊术后盆底功能障碍——一项综合研究。第二部分。

Pelvic floor dysfunction after Burch colposuspension--a comprehensive study. Part II.

作者信息

Kjølhede Preben, Wahlström Johan, Wingren Gun

机构信息

Division of Obstetrics and Gynecology, Faculty of Health Sciences, University Hospital, 581-85 Linköping, Sweden.

出版信息

Acta Obstet Gynecol Scand. 2005 Sep;84(9):902-8. doi: 10.1111/j.0001-6349.2005.00754.x.

Abstract

OBJECTIVE

To evaluate the prevalence of pelvic floor dysfunction (PFD) concerning bowel function at long-term follow-up after Burch colposuspension (Bc) in relation to the bowel function in an age-matched sample of women in the general population.

METHODS AND MATERIAL

This is a follow-up study of a cohort of 190 patients who underwent Bc in 1980-1988 and 305 age-matched control women without urinary anti-incontinence surgery, randomly selected from the general population. The participants answered a postal questionnaire with detailed questions about the pelvic floor function in 1998. Univariate and multivariate analyses were performed.

RESULTS

The patients showed considerable signs of bowel dysfunction compared with the general population in the following aspects: they used the fingers to help emptying the bowel [odds ratio (OR) 3.25 (1.35-7.86)]; had feeling of incomplete emptying of the bowel [OR 2.29 (1.11-4.73)]; felt no warning before passing a motion [OR 3.04 (1.20-7.71)]; had gas incontinence [OR 1.98 (1.17-3.37); had loose stool incontinence [OR 3.67 (1.43-9.42)]; used protection against fecal leakage during daytime [OR 3.22 (1.30-7.95)]; and experienced that the bowel function affected the general well-being adversely [OR 2.15 (1.30-3.56)].

CONCLUSION

The patients who have undergone colposuspension for stress urinary incontinence have more symptoms of PFD concerning the bowel function than women without urinary anti-incontinence surgery in the general population. This affects the general well-being. A comprehensive concept of multidisciplinary assessment and treatment of PFD should be encouraged.

摘要

目的

评估在长期随访中,与年龄匹配的普通人群样本中的肠道功能相关的,经Burch阴道悬吊术(Bc)后盆底功能障碍(PFD)中肠道功能障碍的患病率。

方法和材料

这是一项对1980年至1988年间接受Bc手术的190名患者以及从普通人群中随机选取的305名年龄匹配、未接受尿失禁手术的对照女性进行的队列随访研究。参与者在1998年通过邮寄问卷回答了有关盆底功能的详细问题。进行了单因素和多因素分析。

结果

与普通人群相比,患者在以下方面表现出明显的肠道功能障碍迹象:他们使用手指辅助排便[比值比(OR)3.25(1.35 - 7.86)];有排便不尽感[OR 2.29(1.11 - 4.73)];排便前无便意[OR 3.04(1.20 - 7.71)];有气体失禁[OR 1.98(1.17 - 3.37)];有稀便失禁[OR 3.67(1.43 - 9.42)];白天使用防粪便渗漏保护措施[OR 3.22(1.30 - 7.95)];并且经历肠道功能对总体幸福感有不利影响[OR 2.15(1.30 - 3.56)]。

结论

因压力性尿失禁接受阴道悬吊术的患者,与普通人群中未接受尿失禁手术的女性相比,在肠道功能方面有更多PFD症状。这会影响总体幸福感。应鼓励对PFD进行多学科评估和治疗的综合概念。

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