Division of Gynecology, Department of Obstetrics and Gynecology, Pelvic Floor Research Group, University of Michigan, Ann Arbor, MI, USA.
Am J Obstet Gynecol. 2010 May;202(5):491.e1-6. doi: 10.1016/j.ajog.2010.01.020.
We sought to compare pelvic floor structure and function between older women with and without fecal incontinence (FI) and young continent (YC) women.
YC (n=9) and older continent (OC) (n=9) women were compared to older women with FI (older incontinent [OI]) (n=8). Patients underwent a pelvic organ prolapse quantification, measurement of levator ani (LA) force at rest and with maximum contraction, and magnetic resonance imaging. Displacement of structures and LA defects were determined on dynamic magnetic resonance imaging.
LA defects were more common in the OI vs the YC (75% vs 11%, P=.01) and OC (22%, P=.14) groups; women with FI were more likely to have LA defects than women without (odds ratio, 14.0, 95% confidence interval, 1.8-106.5). OI women generated 27.0% and 30.1% less force during maximum contraction vs the OC (P=.13) and YC (P=.04) groups. During Kegel, OI absolute structural displacements were smaller than in the OC group (P=.01).
OI women commonly have LA defects, and cannot augment pelvic floor strength.
我们旨在比较有和无粪便失禁（FI）的老年女性与年轻对照组（YC）女性之间的盆底结构和功能。
比较 YC（n=9）和老年对照组（OC）（n=9）与老年失禁（OI）（n=8）女性。患者接受了盆腔器官脱垂量化、静息和最大收缩时肛提肌（LA）力量的测量以及磁共振成像检查。在动态磁共振成像上确定结构移位和 LA 缺陷。
OI 组的 LA 缺陷比 YC（75% 对 11%，P=.01）和 OC（22%，P=.14）组更常见；有 FI 的女性比无 FI 的女性更有可能出现 LA 缺陷（比值比，14.0，95%置信区间，1.8-106.5）。OI 女性在最大收缩时产生的力比 OC（P=.13）和 YC（P=.04）组少 27.0%和 30.1%。在凯格尔运动期间，OI 的绝对结构移位比 OC 组小（P=.01）。
OI 女性通常有 LA 缺陷，无法增强盆底强度。
