Weinstein Milena M, Pretorius Dolores H, Jung Sung-Ae, Wan Jennifer J, Nager Charles W, Mittal Ravinder K
The Pelvic Floor Function and Disorder Group, University of California, San Diego, CA, USA.
Int Urogynecol J. 2011 Sep;22(9):1143-50. doi: 10.1007/s00192-011-1446-8. Epub 2011 May 21.
We aimed to determine anatomy and function of anal sphincter complex using three-dimensional ultrasound (3D-US) and manometry in asymptomatic parous women.
3D-US of puborectalis muscle (PRM), external (EAS), and internal anal sphincters (IAS) anatomy was performed in 45 women without pelvic floor dysfunction. To assess function, rest and squeeze vaginal and anal pressures were measured. Based on 3D-US, subjects were divided into injured and uninjured groups.
Forty-four of 45 subjects had adequate PRM images. The injured PRM (N = 14) group had significantly lower vaginal pressures as compared with uninjured PRM group (N = 30; p = 0.001). Four of 45 subjects with IAS and EAS defects had lower resting and squeeze anal canal pressure. Muscle injury to IAS, EAS and PRM in the same individual was uncommon.
In asymptomatic parous women, PRM defects were more common than the EAS/IAS defects but defects in more than one muscle were infrequent. Subjects with injured PRM had low vaginal pressure than the ones without.
我们旨在通过三维超声（3D-US）和测压法确定无症状经产妇肛门括约肌复合体的解剖结构和功能。
对45名无盆底功能障碍的女性进行耻骨直肠肌（PRM）、外括约肌（EAS）和肛门内括约肌（IAS）解剖结构的三维超声检查。为评估功能，测量静息和收缩时的阴道及肛门压力。基于三维超声，将受试者分为损伤组和未损伤组。
45名受试者中有44人获得了足够的耻骨直肠肌图像。与未损伤耻骨直肠肌组（N = 30；p = 0.001）相比，损伤耻骨直肠肌组（N = 14）的阴道压力显著降低。45名存在肛门内括约肌和外括约肌缺陷的受试者中有4人静息和收缩时肛管压力较低。同一个体中肛门内括约肌、外括约肌和耻骨直肠肌同时受损的情况并不常见。
在无症状经产妇中，耻骨直肠肌缺陷比外括约肌/肛门内括约肌缺陷更常见，但多块肌肉同时出现缺陷的情况较少见。耻骨直肠肌受损的受试者阴道压力低于未受损者。
