Hsu Yvonne, Chen Luyun, Tumbarello Julie, Ashton-Miller James A, DeLancey John O L
Department of Ob-Gyn, University of Michigan, Ann Arbor, Michigan, USA.
Int Urogynecol J. 2010 Sep;21(9):1111-5. doi: 10.1007/s00192-010-1154-9. Epub 2010 May 4.
The objective of the study was to compare anterior compartment compliance between women with and without pelvic organ prolapse and to explore factors determining the extent of anterior compartment prolapse.
Ten women with normal pelvic support and nine with anterior compartment prolapse were analyzed. Abdominal pressure was measured during Valsalva and simultaneous midsagittal dynamic MR imaging. The distance between the most dependent anterior vaginal wall point and a previously determined average nulliparous anterior vaginal wall point was measured. A best-fit line was determined when anterior vaginal wall displacement was plotted relative to abdominal pressure. The slope of this line is a measure of anterior compartment compliance. Multivariate analyses and t tests were performed.
Mean compliance (centimeters per centimeter of water) was higher for cases [0.05 +/- 0.006 standard error of the mean (SEM)] than controls (0.03 +/- .007, p = 0.039). Degree of anterior compartment prolapse correlated best with compliance (R (2) = 0.75, p < 0.01) and also with resting anterior vaginal wall point (R (2) = 0.55, p < 0.01).
Women with anterior compartment prolapse have a 67% more compliant support system compared with those with normal support. Both compliance and resting anterior vaginal wall location are predictors of the degree of anterior compartment prolapse.
本研究的目的是比较有和没有盆腔器官脱垂的女性前间隙顺应性，并探索决定前间隙脱垂程度的因素。
对10名盆腔支持正常的女性和9名有前间隙脱垂的女性进行分析。在瓦尔萨尔瓦动作期间测量腹压，并同时进行矢状面动态磁共振成像。测量最下垂的阴道前壁点与先前确定的未生育女性阴道前壁平均点之间的距离。绘制阴道前壁位移相对于腹压的关系图时确定最佳拟合线。这条线的斜率是前间隙顺应性的一个指标。进行多变量分析和t检验。
病例组的平均顺应性（每厘米水柱的厘米数）[0.05±0.006平均标准误（SEM）]高于对照组（0.03±0.007，p = 0.039）。前间隙脱垂程度与顺应性相关性最佳（R² = 0.75，p < 0.01），也与静息时阴道前壁点相关（R² = 0.55，p < 0.01）。
与支持正常的女性相比，有前间隙脱垂的女性其支持系统的顺应性高67%。顺应性和静息时阴道前壁位置都是前间隙脱垂程度的预测指标。
