女性盆底康复医学中的便秘模式：临床重要性及病理生理学见解
Patterns of constipation in urogynecology: clinical importance and pathophysiologic insights.
作者信息
Soligo Marco, Salvatore Stefano, Emmanuel Anton V, De Ponti Elena, Zoccatelli Marco, Cortese Marina, Milani Rodolfo
机构信息
Department of Gynecological Surgery, University of Milan-Bicocca-Bassini Hospital, Cinisello Balsamo (Milano), Italy.
出版信息
Am J Obstet Gynecol. 2006 Jul;195(1):50-5. doi: 10.1016/j.ajog.2005.12.046. Epub 2006 Apr 21.
OBJECTIVE
We have analyzed the prevalence and patterns of constipation in women with urinary symptoms and/or genital prolapse.
STUDY DESIGN
Seven hundred and eighty-six consecutive urogynecologic patients underwent a questionnaire and structured clinical assessment. Comparison between constipated and nonconstipated women was made. Fisher exact test, Wilcoxon rank sum test, and logistic regression were used for statistical analysis (P < .05 for significance).
RESULTS
Thirty-two percent of women were constipated (172 difficult stool passage, 13 reduced stool frequency, 64 both). A genital prolapse > or = 2 degree Half Way System (HWS) was present in 44% of women. A posterior colpocele was more frequent in constipated women (35% vs 19%; P < .0001), resulting in a risk factor for constipation (OR 2.31; 95% CI 1.63-3.27). By contrast, higher degrees of anterior colpocele appeared to protect against constipation (OR 0.80; 95% CI 0.66-0.96). No differences in prevalence of constipation were observed for urinary symptoms or urodynamic diagnosis.
CONCLUSION
Bowel dysfunction correlates exclusively with posterior aspects of the pelvic floor support.
目的
我们分析了有泌尿系统症状和/或生殖器脱垂的女性中便秘的患病率及模式。
研究设计
786例连续的泌尿妇科患者接受了问卷调查和结构化临床评估。对便秘女性和非便秘女性进行了比较。采用Fisher精确检验、Wilcoxon秩和检验及逻辑回归进行统计分析（P <.05为有显著性）。
结果
32%的女性存在便秘（172例排便困难，13例排便次数减少，64例两者皆有）。44%的女性存在≥2度的生殖器脱垂（半程系统[HWS]）。便秘女性中后盆腔膨出更为常见（35%对19%；P <.0001），成为便秘的一个危险因素（比值比[OR] 2.31；95%可信区间[CI] 1.63 - 3.27）。相比之下，较高程度的前盆腔膨出似乎可预防便秘（OR 0.80；95% CI 0.66 - 0.96）。在泌尿系统症状或尿动力学诊断方面，未观察到便秘患病率的差异。
结论
肠道功能障碍仅与盆底支持结构的后部相关。
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