Vitton Veronique, Luciano Laure, Ortiz Sandra, Baumstarck Karine, Bouvier Michel
Service de Gastroentérologie, CHU Nord, Aix-Marseille Université, Marseille, France.
Department of Gastroenterology, Instruction Hospital of French Army Laveran, Marseille, France.
Int Urogynecol J. 2019 Dec;30(12):2049-2054. doi: 10.1007/s00192-019-03902-3. Epub 2019 Feb 22.
Wearing high heels may not only produce deleterious effects on the musculoskeletal system and on the general posture, but also on the activity of pelvic floor muscles. However, no data are currently available concerning the link between fecal incontinence and wearing high heels. Our aim was to determine whether wearing high-heeled shoes could influence anal canal pressure values in patients suffering from fecal incontinence.
In this retrospective monocentric study, 338 female patients were included. Clinical data, including the Wexner score, and manometric data were recorded (using 3D high-resolution anorectal manometry). Wearing high heels was defined by the use of high-heeled shoes at least four times a week for 4 consecutive hours with at least 1 year of usage time and heels ≥3 cm. Two sub-groups were defined: "high heels" vs "no high heels."
The two subgroups were comparable for clinical data, including Wexner score, except for a higher age, menopause and hormone replacement therapy, and urinary incontinence in the group with "high heels." No statistical difference was observed concerning the anal canal pressure. Using analysis by logistic regression, only age was related to a significantly lower resting pressure.
In this retrospective cohort of women with fecal incontinence, no clinical or manometric differences were observed between women who wore high heels versus those who did not. Because there is limited knowledge on this potential link and because the pelvic tilt may vary according to age and the habit of walking with high heels, further studies are necessary.
穿高跟鞋不仅可能对肌肉骨骼系统和总体姿势产生有害影响，还可能影响盆底肌肉的活动。然而，目前尚无关于大便失禁与穿高跟鞋之间联系的数据。我们的目的是确定穿高跟鞋是否会影响大便失禁患者的肛管压力值。
在这项回顾性单中心研究中，纳入了338名女性患者。记录临床数据，包括韦克斯纳评分，并记录测压数据（使用三维高分辨率肛肠测压法）。穿高跟鞋的定义为每周至少穿4次高跟鞋，每次连续穿4小时，使用时间至少1年，鞋跟≥3厘米。定义了两个亚组：“高跟鞋组”与“无高跟鞋组”。
除年龄较大、处于更年期和接受激素替代治疗以及“高跟鞋组”存在尿失禁外，两个亚组在包括韦克斯纳评分在内的临床数据方面具有可比性。在肛管压力方面未观察到统计学差异。使用逻辑回归分析，只有年龄与静息压力显著降低有关。
在这项大便失禁女性的回顾性队列研究中，穿高跟鞋的女性与未穿高跟鞋的女性之间在临床或测压方面未观察到差异。由于对这一潜在联系的了解有限，且骨盆倾斜可能因年龄和穿高跟鞋行走的习惯而异，因此有必要进行进一步研究。
