Summers Aimee, Winkel Lisa A, Hussain Hero K, DeLancey John O L
Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.
Am J Obstet Gynecol. 2006 May;194(5):1438-43. doi: 10.1016/j.ajog.2006.01.057. Epub 2006 Mar 30.
The purpose of this study was to determine whether the degree of anterior compartment (bladder) and apical compartment (cervix) prolapse are correlated, and whether 2 anterior compartment elements (urethra and bladder) are related at maximal Valsalva.
Women with a complete spectrum of pelvic support were recruited for a pelvic support study. Dynamic magnetic resonance scans were taken during Valsalva. A convenience sample of 153 women with a mean age of 53.3 +/- 12.5 (SD) years with a uterus in situ was studied. Anterior compartment status was assessed by the most caudal bladder point and the internal urinary meatus. The external cervical os was used to assess the apical compartment. The position of the bladder, urethra, and uterus were determined in 20 nulliparous women to determine their reference locations. The distances of each structure below the reference positions were calculated at maximum Valsalva.
Average distances of the bladder base, urethra, and uterus from the reference positions at maximal Valsalva were 4.1 +/- 2.4 cm, 3.1 +/- 1.3 cm, and 4.3 +/- 2.4 cm, respectively. The Pearson correlation coefficient of the relationship between the bladder base and uterine distances was r = 0.73 (r2 = 0.53). The Pearson correlation coefficient of the bladder distance and urethral distance was r = 0.82 (r2 = 0.67).
Half of the observed variation in anterior compartment support may be explained by apical support.
本研究旨在确定前盆腔（膀胱）和顶端盆腔（宫颈）脱垂程度是否相关，以及在最大瓦氏动作时前盆腔的两个组成部分（尿道和膀胱）是否相关。
招募具有完整盆腔支持谱的女性进行盆腔支持研究。在瓦氏动作期间进行动态磁共振扫描。对153名平均年龄为53.3±12.5（标准差）岁且子宫在位的女性进行便利抽样研究。通过膀胱最尾端点和尿道内口评估前盆腔状态。通过宫颈外口评估顶端盆腔。在20名未生育女性中确定膀胱、尿道和子宫的位置以确定其参考位置。在最大瓦氏动作时计算每个结构低于参考位置的距离。
在最大瓦氏动作时，膀胱底部、尿道和子宫距参考位置的平均距离分别为4.1±2.4厘米、3.1±1.3厘米和4.3±2.4厘米。膀胱底部与子宫距离之间关系的Pearson相关系数为r = 0.73（r2 = 0.53）。膀胱距离与尿道距离的Pearson相关系数为r = 0.82（r2 = 0.67）。
观察到的前盆腔支持变化的一半可能由顶端支持来解释。
