Department of Gynecology and Obstetrics, Division of Female Pelvic Medicine and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, 301 Building, Suite 3200, Baltimore, MD, 21224, USA.
Int Urogynecol J. 2021 Apr;32(4):829-834. doi: 10.1007/s00192-020-04569-x. Epub 2020 Oct 20.
Pelvic organ prolapse (POP) severity is poorly correlated with prolapse symptoms. The objective of this study was to investigate the association between genital hiatus (GH) size and presence and severity of bulge symptoms.
This analysis utilized data from a longitudinal study of parous women. Women underwent annual assessment of POP, GH size, and bulge symptoms. "Bother" was scored by participants reporting bulge symptoms. Three analyses evaluated the association between GH size and bulge symptoms, each using linear mixed models. First, we compared case visits (bulge symptoms reported) to control visits (bulge symptoms never reported), matching for stage. Second, among women who reported bulge sensation at least once during the study, we compared GH size at visits with and without bulge symptoms. Third, among women who reported bulge sensation, we investigated whether GH size was associated with "bother" score, controlling for stage.
Of 1528 women (7440 visits), 148 women (803 visits) reported bulge symptoms at ≥ 1 visit and 1380 women never reported bulge symptoms (6637 visits). Comparing 315 case visits (bulge symptoms reported) to 1260 control visits (bulge symptoms never reported), GH size was significantly greater among case visits (3.05 cm versus 2.85 cm, p ≤ 0.0001). In the case-crossover analysis, GH size was similar for visits with and without bulge symptoms (p = 0.63). When evaluating GH size and degree of bulge symptom bother, bother severity was significantly associated with GH size (p = 0.003).
Independent of stage, GH size was significantly associated with prolapse bulge symptoms and bother severity.
盆腔器官脱垂 (POP) 的严重程度与脱垂症状相关性较差。本研究的目的是探讨生殖器裂孔 (GH) 大小与膨出症状的存在和严重程度之间的关系。
本分析利用了一项多胎妇女纵向研究的数据。女性每年接受 POP、GH 大小和膨出症状的评估。“困扰”由报告膨出症状的参与者评分。三种分析评估了 GH 大小与膨出症状之间的关联，每种分析均使用线性混合模型。首先，我们比较了病例访视（报告膨出症状）与对照访视（从未报告膨出症状），并按阶段匹配。其次，在至少一次报告膨出感觉的女性中，我们比较了有膨出症状和无膨出症状访视时的 GH 大小。第三，在报告膨出感觉的女性中，我们调查了 GH 大小与“困扰”评分的关系，同时控制了阶段。
在 1528 名女性（7440 次就诊）中，148 名女性（803 次就诊）报告至少一次就诊时有膨出症状，1380 名女性从未报告过膨出症状（6637 次就诊）。比较 315 次病例就诊（报告膨出症状）和 1260 次对照就诊（从未报告膨出症状），病例就诊时 GH 大小明显更大（3.05cm 比 2.85cm，p≤0.0001）。在病例交叉分析中，有膨出症状和无膨出症状的就诊时 GH 大小相似（p=0.63）。当评估 GH 大小和膨出症状困扰程度时，困扰严重程度与 GH 大小显著相关（p=0.003）。
独立于阶段，GH 大小与脱垂膨出症状和困扰严重程度显著相关。
