Noguti Alberto S, Jarmy-Di Bella Zsuzsanna I K, de Oliveira Emerson, Castro Rodrigo A, Lima Geraldo R, Baracat Edmund Chada, Sartori Marair G F, Girão Manoel J B C
Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil.
Eur J Obstet Gynecol Reprod Biol. 2008 Dec;141(2):183-5. doi: 10.1016/j.ejogrb.2008.06.008. Epub 2008 Aug 26.
We aimed to study the cross-sectional area of levator ani muscle and the doppler velocimetric parameters of vessels its in premenopausal and postmenopausal women.
Sixty-four patients, divided into 3 groups, were assessed: group I (20 women-average age 28 years) premenopausal and nulliparous (control); group II (24 women-average age 38 years, vaginal delivery 1-4) premenopausal with vaginal deliveries; group III (20 women-average age 55 years, parity 0-4) postmenopausal without hormonal therapy. Doppler velocimetry of levator ani muscle vessels through resistance and pulsatility indices was used and the means of the groups compared by adjusting the weighed variance model with multiple comparisons, according to Tukey's method. Similarly, we measured the cross-sectional area of the muscle using ultrasonography.
There was a significant increase in resistance and pulsatility indices in postmenopausal patients as compared to the other two groups. We also observed a significant decrease in the cross-sectional area of the muscle of postmenopausal patients when compared to those in premenopausal.
The obtained results allow us to conclude that levator ani muscle vascularization significantly decreases after menopause (age and/or hipoestrogenism) and that it can be assumed that vaginal delivery does not promote long-term alterations in levator ani muscle vascularization. We also observed a significant decrease in the cross-sectional area of the muscle in postmenopausal women when compared to those in premenopausal.
我们旨在研究绝经前和绝经后女性肛提肌的横截面积及其血管的多普勒测速参数。
对64例患者进行评估，分为3组：第一组（20名女性，平均年龄28岁），绝经前未生育（对照组）；第二组（24名女性，平均年龄38岁，有1 - 4次阴道分娩史），绝经前有阴道分娩史；第三组（20名女性，平均年龄55岁，产次0 - 4），绝经后未接受激素治疗。通过阻力和搏动指数对肛提肌血管进行多普勒测速，并根据Tukey法，采用加权方差模型进行多重比较来比较各组均值。同样，我们使用超声测量肌肉的横截面积。
与其他两组相比，绝经后患者的阻力和搏动指数显著增加。与绝经前患者相比，我们还观察到绝经后患者肌肉的横截面积显著减小。
所得结果使我们得出结论，绝经后（年龄和/或雌激素缺乏）肛提肌血管化显著降低，并且可以认为阴道分娩不会促进肛提肌血管化的长期改变。与绝经前女性相比，我们还观察到绝经后女性肌肉的横截面积显著减小。
