Pelvic Floor Research Group, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA.
Neurourol Urodyn. 2013 Jan;32(1):37-42. doi: 10.1002/nau.22275. Epub 2012 Jun 5.
To test the null hypothesis that bony pelvis dimensions are similar in women with and without stress urinary incontinence (SUI), both in the postpartum and midlife periods.
Secondary analyses were performed of two case-control studies comparing women with SUI to asymptomatic controls. One study examined primiparas in the first 9-12 months postpartum; the other study involved middle-aged women. SUI was confirmed by full-bladder stress test. All subjects underwent pelvic magnetic resonance imaging. The interspinous and intertuberous diameters, subpubic angle, and sacrococcygeal joint-to-the inferior pubic point distance were measured from the images independently by two authors.
In the young cohorts, we compared primiparas with de novo postpartum SUI to both continent primiparas and nulliparas. Postpartum SUI is associated with a wider subpubic angle. There is also a trend towards wider interspinous and intertuberous diameters in the stress-incontinent primiparas as compared to the continent cohorts, although this did not reach statistical significance with our sample sizes. By contrast, no significant differences in bony pelvis dimensions were identified when comparing middle-aged women with SUI and their continent controls.
Bony pelvis dimensions are different in women with SUI than in matched continent controls. However, these differences are only identified in young primiparas in the postpartum period, not in middle-aged women.
检验骨盆腔尺寸在产后和中年时期有压力性尿失禁(SUI)和无症状的女性中相似的零假设。
对两项病例对照研究进行二次分析,将有 SUI 的女性与无症状对照进行比较。一项研究在产后 9-12 个月时检查初产妇;另一项研究涉及中年女性。通过全膀胱压力测试确认 SUI。所有受试者均接受骨盆磁共振成像。由两位作者独立从图像上测量棘突间和棘突间直径、耻骨下角和骶尾关节至耻骨下点的距离。
在年轻队列中,我们将产后新发 SUI 的初产妇与有尿控的初产妇和未产妇进行比较。产后 SUI 与耻骨下角更宽有关。与有尿控的队列相比,压力性尿失禁的初产妇的棘突间和棘突间直径也有增宽的趋势,但在我们的样本量下,这并没有达到统计学意义。相比之下,在比较中年有 SUI 的女性及其有尿控的对照组时,骨盆腔尺寸没有明显差异。
与匹配的有尿控的对照组相比,SUI 女性的骨盆腔尺寸不同。然而,这些差异仅在产后的年轻初产妇中被识别,而在中年女性中没有被识别。