Department of Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Gynecology, Hangzhou Women's Hospital, Hangzhou, Zhejiang, China.
Gynecol Obstet Invest. 2019;84(6):599-605. doi: 10.1159/000501825. Epub 2019 Jul 23.
Early evaluation of pelvic floor muscle (PFM) in postpartum women is important for the treatment of stress urinary incontinence (SUI). Digital vaginal palpation and electromyography (EMG) evaluation based on Glazer protocol are widely used for the assessment of PFM. However, the correlation among digital palpation, EMG, and morbidity of postpartum SUI is still unclear. This study aims to investigate the relationship between postpartum SUI and PFM examinations.
This hospital-based cross-sectional study included 1,380 parturients during September 2016 to January 2018. We collected the clinical characteristics, PFM strength, and EMG variables of parturients 6-8 weeks after birth. Then the correlation among the results of EMG, digital palpation, and the occurrence of SUI was analyzed.
There is no significant difference in digital palpation scores of PFM strength between SUI and non-SUI parturients. The EMG values were closely related to SUI: the multivariate logistic regression revealed that the most reliable evaluation indicators of postpartum SUI were pelvic floor contractile amplitude of endurance contraction (B = 0.021, p = 0.019) and pretest resting baseline (B = 0.056, p = 0.019). Correlation analysis demonstrated that the contraction variables of EMG had a significant correlation with the digital palpation PFM strength in postpartum women (r = 0.467-0.545, p < 0.001).
The EMG proved to be reliable in assessing the PFM function in postpartum women. The decreased PFM activity, according to EMG, was correlated with postpartum SUI. Although digital palpation scores were positively correlated with EMG results, no correlation was observed with SUI incidence.
产后女性盆底肌(PFM)的早期评估对于治疗压力性尿失禁(SUI)很重要。基于 Glazer 方案的数字阴道触诊和肌电图(EMG)评估广泛用于 PFM 的评估。然而,数字触诊、EMG 与产后 SUI 发病率之间的相关性仍不清楚。本研究旨在探讨产后 SUI 与 PFM 检查之间的关系。
这是一项基于医院的横断面研究,纳入了 2016 年 9 月至 2018 年 1 月的 1380 名产妇。我们收集了产后 6-8 周产妇的临床特征、PFM 强度和 EMG 变量。然后分析了 EMG、数字触诊和 SUI 发生之间的关系。
SUI 和非 SUI 产妇的 PFM 强度数字触诊评分无显著差异。EMG 值与 SUI 密切相关:多变量逻辑回归显示,产后 SUI 最可靠的评估指标是盆底收缩耐力收缩的收缩幅度(B = 0.021,p = 0.019)和预测试休息基线(B = 0.056,p = 0.019)。相关性分析表明,EMG 的收缩变量与产后女性的数字触诊 PFM 强度有显著相关性(r = 0.467-0.545,p < 0.001)。
EMG 被证明可用于可靠地评估产后女性的 PFM 功能。根据 EMG,PFM 活性降低与产后 SUI 相关。尽管数字触诊评分与 EMG 结果呈正相关,但与 SUI 发生率无相关性。