盆底收缩功能减退的有症状患者中主要提肌异常的患病率
Prevalence of major levator abnormalities in symptomatic patients with an underactive pelvic floor contraction.
作者信息
Steensma Anneke B, Konstantinovic Maja L, Burger Curt W, de Ridder Dirk, Timmerman Dirk, Deprest Jan
机构信息
Department of Gynaecology and Gynaecooncology, Erasmus Medical Center, Rotterdam, The Netherlands.
出版信息
Int Urogynecol J. 2010 Jul;21(7):861-7. doi: 10.1007/s00192-010-1111-7. Epub 2010 Mar 4.
INTRODUCTION AND HYPOTHESIS
Major levator ani abnormalities (LAA) may lead to abnormal pelvic floor muscle contraction (pfmC) and secondarily to stress urinary incontinence (SUI), prolapse, or fecal incontinence (FI).
METHODS
A retrospective observational study included 352 symptomatic patients to determine prevalence of LAA in underactive pfmC and the relationship with symptoms. On 2D/3D transperineal ultrasound, PfmC was subjectively assessed as underactive (UpfmC) or normal (NpfmC) and quantified. LAA, defined as a complete avulsion of the pubic bone, was analyzed using tomographic ultrasound imaging.
RESULTS
LAA were found in 53.8% of women with UpfmC versus 16.1% in NpfmC (P < 0.001). Patients with UpfmC were less likely to reduce hiatal area on pfmC (mean 7% reduction vs 25% in NpfmC (P < 0.001)). An UpfmC was associated with FI (P = 0.002), not with SUI or prolapse of the anterior and central compartment.
CONCLUSION
An underactive pfmC is associated with increased prevalence of LAA and FI.
引言与假设
肛提肌主要异常（LAA）可能导致盆底肌肉收缩异常（pfmC），进而引发压力性尿失禁（SUI）、脏器脱垂或大便失禁（FI）。
方法
一项回顾性观察研究纳入了352例有症状的患者，以确定盆底肌肉收缩功能减退（pfmC）中LAA的患病率及其与症状的关系。通过二维/三维经会阴超声，主观评估pfmC为功能减退（UpfmC）或正常（NpfmC）并进行量化。使用断层超声成像分析定义为耻骨完全撕脱的LAA。
结果
盆底肌肉收缩功能减退（UpfmC）的女性中53.8%存在LAA，而盆底肌肉收缩功能正常（NpfmC）的女性中这一比例为16.1%（P < 0.001）。盆底肌肉收缩功能减退（UpfmC）的患者在盆底肌肉收缩时缩小裂孔面积的可能性较小（平均缩小7%，而盆底肌肉收缩功能正常（NpfmC）的患者为25%，P < 0.001）。盆底肌肉收缩功能减退（UpfmC）与大便失禁（FI）相关（P = 0.002），与压力性尿失禁（SUI）或前盆腔和中盆腔脏器脱垂无关。
结论
盆底肌肉收缩功能减退（pfmC）与LAA及大便失禁（FI）患病率增加相关。
Zotero 插件