Murad-Regadas Sthela M, Regadas Francisco Sérgio P, Rodrigues Lusmar V, Oliveira Leticia, Barreto Rosilma G L, de Souza Marcellus H L P, Silva Flavio Roberto S
Department of Surgery, School of Medicine of the Federal University of Ceara, Clinic Hospital, Federal University of Ceara, Av Pontes Vieira, 2551, Fortaleza, Ceará, 60130-241, Brazil.
Int J Colorectal Dis. 2009 Oct;24(10):1227-32. doi: 10.1007/s00384-009-0746-7. Epub 2009 Jun 3.
This study aims to show pelvic floor dysfunctions in women with obstructed defecation syndrome (ODS), comparing nulliparous to those with vaginal delivery or cesarean section using the echodefecography (ECD).
Three hundred seventy female patients with ODS were reviewed retrospectively and were divided in Group I-105 nulliparous, Group II-165 had at least one vaginal delivery, and Group III-comprised of 100 patients delivered only by cesarean section. All patients had been submitted to ECD to identify pelvic floor dysfunctions.
No statistical significance was found between the groups with regard to anorectocele grade. Intussusception was identified in 40% from G I, 55.0% from G II, and 30.0% from G III, with statistical significance between Groups I and II. Intussusception was associated with significant anorectocele in 24.8%, 36.3%, and 18% patients from G I, II, and III, respectively. Anismus was identified in 39.0% from G I, 28.5% from G II, and 60% from G III, with statistical significance between Groups I and III. Anismus was associated with significant anorectocele in 22.8%, 15.7%, and 24% patients from G I, II, and III, respectively. Sigmoidocele/enterocele was identified in 7.6% from G I, 10.9% G II, and was associated with significant rectocele in 3.8% and 7.3% patients from G I and II, respectively.
The distribution of pelvic floor dysfunctions showed no specific pattern across the groups, suggesting the absence of a correlation between these dysfunctions and vaginal delivery.
本研究旨在通过排粪造影(ECD)比较未生育女性与经阴道分娩或剖宫产的女性排便障碍综合征(ODS)患者的盆底功能障碍情况。
回顾性分析370例ODS女性患者,分为三组:I组105例未生育女性,II组165例至少有一次经阴道分娩,III组100例仅行剖宫产。所有患者均接受ECD检查以确定盆底功能障碍情况。
各组间直肠膨出分级无统计学差异。I组肠套叠发生率为40%,II组为55.0%,III组为30.0%,I组和II组间有统计学差异。I组、II组和III组分别有24.8%、36.3%和18%的患者肠套叠合并明显直肠膨出。I组耻骨直肠肌痉挛发生率为39.0%,II组为28.5%,III组为60%,I组和III组间有统计学差异。I组、II组和III组分别有22.8%、15.7%和24%的患者耻骨直肠肌痉挛合并明显直肠膨出。I组乙状结肠膨出/小肠膨出发生率为7.6%,II组为10.9%,I组和II组分别有3.8%和7.3%的患者乙状结肠膨出/小肠膨出合并明显直肠膨出。
各组盆底功能障碍分布无特定模式,提示这些功能障碍与经阴道分娩之间无相关性。