Department of Midwifery, Marand Branch, Islamic Azad University, Marand, Iran.
Reproductive Health Promotion Research Center, Midwifery and Reproductive Health Department, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Int Urogynecol J. 2021 Aug;32(8):2095-2109. doi: 10.1007/s00192-020-04639-0. Epub 2021 Feb 1.
Pelvic organ prolapse (POP) is a very common and distressing problem that affects women's quality of life. This systematic review aimed to investigate the association of the dimensions of the genital hiatus and levator hiatus at rest and Valsalva with POP.
The Cochrane Library, PubMed, Scopus, Embase and Web of Science were searched on 25 April 2020. All data were analyzed using Review Manager 5.3.
Of the 1288 papers reviewed, 21 (n = 5145: 2909 women with POP and 2236 controls) were considered for meta-analysis. Compared with the normal pelvic floor group, the urogenital hiatus size in the POP group was significantly higher at rest (mean difference: 0.49; 95% CI: [0.43, 0.55], P < 0.00001) and at Valsalva (mean difference: 0.79; 95% CI: [0.70, 0.89], P < 0.00001). Also, the levator ani hiatus size in the POP group was significantly higher at rest (mean difference: 0.52, 95% CI: [0.25, 0.78], P < 0.0001) and at Valsalva (mean difference: 1.01; 95% CI: [0.73,1.28], P < 0.00001) compared with that in the normal pelvic floor group.
This systematic review showed that the sizes of the urogenital hiatus and levator ani hiatus and area of the levator hiatus in the POP group were significantly higher than those in the normal pelvic floor groups in both positions (rest or Valsalva maneuver). Also, in the POP group, the levator hiatus length at rest was significantly lower than that in the Valsalva maneuver.
盆腔器官脱垂（POP）是一种非常常见且令人痛苦的问题，会影响女性的生活质量。本系统评价旨在探讨静止和valsalva 时会阴体裂孔和肛提肌裂孔的维度与 POP 的关系。
于 2020 年 4 月 25 日检索 Cochrane 图书馆、PubMed、Scopus、Embase 和 Web of Science。所有数据均使用 Review Manager 5.3 进行分析。
在审查的 1288 篇论文中，有 21 篇（n=5145：2909 名患有 POP 的女性和 2236 名对照）被认为适合进行荟萃分析。与正常盆底组相比，POP 组在静止时（平均差异：0.49；95%可信区间：[0.43，0.55]，P<0.00001）和valsalva 时（平均差异：0.79；95%可信区间：[0.70，0.89]，P<0.00001）的会阴体裂孔大小明显更大。此外，POP 组在静止时（平均差异：0.52；95%可信区间：[0.25，0.78]，P<0.0001）和valsalva 时（平均差异：1.01；95%可信区间：[0.73，1.28]，P<0.00001）的肛提肌裂孔大小明显大于正常盆底组。
本系统评价显示，在静止或valsalva 动作时，POP 组的会阴体裂孔和肛提肌裂孔大小以及肛提肌裂孔面积均明显大于正常盆底组，且 POP 组在静止时的肛提肌裂孔长度明显小于valsalva 动作时。
