Grimes C L, Tan-Kim J, Nager C W, Dyer K Y, Menefee S A, Diwadkar G B, Overholser R H, Xu R, Lukacz E S
Division of Gynecologic Surgical Services and Urogynecology, Columbia University Medical Center, 161 Fort Washington Ave, 4th Floor, New York, NY, 10032, USA,
Int Urogynecol J. 2014 Jul;25(7):893-9. doi: 10.1007/s00192-013-2303-8. Epub 2014 Jan 29.
Optimal measures for assessing anatomy and defecatory symptoms related to posterior compartment prolapse are unknown. Our objectives were: (1) to test the inter- and intrarater reliability of commonly used or reported anatomic measures of posterior compartment prolapse performed in the clinic setting and under anesthesia; and (2) to examine the correlation between posterior compartment anatomy and defecatory symptoms prior to surgical intervention.
A prospective cohort of women with pelvic floor disorders was assessed using a variety of validated questionnaires and standardized examination measures at baseline, at a preoperative visit, and intraoperatively. Inter- and intrarater reliability for anatomic measures were assessed by two separate examiners at the initial visit and repeated by one of the original examiners at a preoperative visit. Reliability was measured using kappa or intraclass correlations according to data type. Symptom and anatomic measure correlations were analyzed using Spearman rank tests.
Mean age of the 120 women recruited was 57 ± 15 years, 49 (41 %) had a point Bp ≥ 0; 59 % reported at least moderate bother from at least one obstructed defecation symptom on the Pelvic Floor Distress Inventory (PFDI). At baseline, most anatomic measures showed at least moderate to good inter/intrarater reliability (> 0.5). There were no moderate or better correlations between any symptom and anatomic measure (all r < 0.27).
Most anatomic measures of posterior compartment prolapse are reliable and reproducible; however, they do not correlate well with defecatory symptoms.
评估与后盆腔脏器脱垂相关的解剖结构和排便症状的最佳方法尚不清楚。我们的目标是：（1）测试在临床环境和麻醉状态下常用的或已报道的后盆腔脏器脱垂解剖测量方法的评分者间信度和评分者内信度；（2）在手术干预前检查后盆腔脏器解剖结构与排便症状之间的相关性。
对一组患有盆底功能障碍的女性进行前瞻性队列研究，在基线、术前访视和术中使用各种经过验证的问卷和标准化检查方法进行评估。解剖测量的评分者间信度和评分者内信度由两名独立的检查者在初次访视时进行评估，并由其中一名原始检查者在术前访视时重复评估。根据数据类型，使用kappa系数或组内相关系数来测量信度。使用Spearman秩检验分析症状与解剖测量之间的相关性。
招募的120名女性的平均年龄为57±15岁，49名（41%）的Bp点≥0；59%的女性在盆底困扰量表（PFDI）上报告至少有一种排便梗阻症状带来至少中度困扰。在基线时，大多数解剖测量显示出至少中度到良好的评分者间/评分者内信度（>0.5）。任何症状与解剖测量之间均无中度或更好的相关性（所有r<0.27）。
大多数后盆腔脏器脱垂的解剖测量方法是可靠且可重复的；然而，它们与排便症状的相关性不佳。
