Nichols Catherine Matthews, Ramakrishnan Viswanathan, Gill Edward J, Hurt W Glenn
Department of Obstetrics and Gynecology, Medical College of Virginia/Virginia Commonwealth University Medical Center, Richmond Virginia, USA.
Obstet Gynecol. 2005 Dec;106(6):1266-71. doi: 10.1097/01.AOG.0000187303.43011.12.
To compare the prevalence of anal incontinence and anal sphincter injury in women with pelvic floor disorders (cases) with those in a group of normal control subjects and to evaluate the relationship between sphincter injury and anal incontinence in each group.
We previously reported the results of a cross-sectional study of 100 women with pelvic floor disorders (> or = stage II pelvic organ prolapse and/or urinary incontinence). In this study, we compared those cases with 90 controls (stage 0 or I pelvic organ prolapse and no urinary incontinence) who completed the Rockwood-Thompson fecal incontinence severity index, in which scoring (0-61) is based on the frequency and type of anal incontinence. All women underwent endoanal ultrasonography, and the internal and external anal sphincters were reported as intact versus disrupted. Chi-square test, Student t test, and logistic regression were used for statistical analysis.
Women with pelvic floor disorders were significantly more likely to report anal incontinence (54% versus 17.8%, odds ratio [OR] 5.4, 95% confidence interval [CI] 2.8-10.6, P < .001) and had higher mean fecal incontinence severity index scores (22.3 +/- 13 versus 12.7 +/- 6.3, P = .006) than controls. Cases demonstrated higher rates of anal sphincter defects on ultrasound examination than did controls (52% versus 30%, P = .007). Anal incontinence was significantly associated with anal sphincter injury in women with pelvic floor disorders (OR 36.4, 95% CI 12-114, P < .001) and in controls (OR 5.9, 95% CI 3-11, P = .002).
Anal incontinence was more common in women with pelvic floor disorders than normal controls and may be due to higher rates of anatomic anal sphincter disruption in this group.
比较盆底功能障碍女性（病例组）与正常对照组肛门失禁及肛门括约肌损伤的患病率，并评估每组中括约肌损伤与肛门失禁之间的关系。
我们之前报告了一项对100名盆底功能障碍女性（≥Ⅱ期盆腔器官脱垂和/或尿失禁）的横断面研究结果。在本研究中，我们将这些病例与90名对照组女性（0或Ⅰ期盆腔器官脱垂且无尿失禁）进行比较，对照组女性完成了Rockwood-Thompson大便失禁严重程度指数评估，该指数评分（0 - 61分）基于肛门失禁的频率和类型。所有女性均接受了肛管超声检查，并报告内外肛门括约肌是否完整。采用卡方检验、学生t检验和逻辑回归进行统计分析。
盆底功能障碍女性报告肛门失禁的可能性显著高于对照组（54%对17.8%，优势比[OR] 5.4，95%置信区间[CI] 2.8 - 10.6，P <.001），且大便失禁严重程度指数平均得分更高（22.3±13对12.7±6.3，P =.006）。病例组超声检查显示肛门括约肌缺陷的发生率高于对照组（52%对30%，P =.007）。在盆底功能障碍女性中，肛门失禁与肛门括约肌损伤显著相关（OR 36.4，95% CI 12 - 114，P <.001），在对照组中也是如此（OR 5.9，95% CI 3 - 11，P =.002）。
盆底功能障碍女性肛门失禁比正常对照组更常见，可能是由于该组解剖学上肛门括约肌断裂的发生率更高。
