Department of OB/Gyn, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng Dist., Beijing, 100044, China.
Beijing Key Laboratory of Female Pelvic Floor Disorders, Beijing, China.
Arch Gynecol Obstet. 2022 Feb;305(2):397-406. doi: 10.1007/s00404-021-06290-6. Epub 2021 Oct 28.
To evaluate the pelvic floor muscle function (PFMF) of cervical cancer patients after type QM-C hysterectomy and to explore the relationship between decreased PFMF and related factors.
This was a multi-centered retrospective cohort study. 181 cervical cancer patients who underwent type QM-C hysterectomy were enrolled from 9 tertiary hospitals. Strength of PFMF were measured using neuromuscular apparatus (Phenix U8, French). Risk factors contributing to decreased PFMF were analyzed by univariate and multivariate ordinal polytomous logistic regression.
Totally 181 patients were investigated in this study. 0-3 level of type I muscle fibre strength (MFSI) was 52.6% (95/181), 0-3 level of type IIA muscle fibre strength (MFSIIA) was 50% (91/181). Subjective stress urinary incontinence was 46% (84/181), urinary retention was 27.3% (50/181), dyschezia was 41.5% (75/181), fecal incontinence was 9% (18/181). ① MFSI: Multivariate ordinal polytomous logistic regression shows that the follow-up time (p < 0.05), chemotherapy and radiotherapy (p = 0.038) are independent risk factors of MFSI's reduction after type QM-C hysterectomy. ② MFSIIA: multivariate ordinal polytomous logistic regression shows that the follow-up time (p < 0.05) are independent risk factors of MFSIIA's reduction after type QM-C hysterectomy. The pelvic floor muscle strength (PFMS) increased after 9 months than in 9 months after operation, which showed that the PFMS could be recovered after operation.
We advocate for more attention and emphasis on the PFMF of Chinese female patients with cervical cancer postoperation.
PEKING UNIVERSITY PEOPLE'S HOSPITAL: PFMF after QM-C hysterectomy has not been analyzed by current study. The contribution is that patients with radical hysterectomy should do pelvic floor rehabilitation exercises in 3 months after operation. Clinical Trails NCT number of this study is 02492542.
评估 QM-C 子宫切除术治疗宫颈癌患者的盆底肌功能（PFMF），并探讨盆底肌功能下降与相关因素的关系。
这是一项多中心回顾性队列研究。纳入 9 家三甲医院的 181 例接受 QM-C 子宫切除术的宫颈癌患者。采用神经肌肉仪（法国 Phenix U8）测量盆底肌功能。采用单因素和多因素有序多项逻辑回归分析导致盆底肌功能下降的危险因素。
本研究共纳入 181 例患者。Ⅰ型肌纤维力量（MFSI）0-3 级占 52.6%（95/181），ⅡA型肌纤维力量（MFSIIA）0-3 级占 50%（91/181）。主观压力性尿失禁占 46%（84/181），尿潴留占 27.3%（50/181），排便困难占 41.5%（75/181），粪便失禁占 9%（18/181）。①MFSI：多因素有序多项逻辑回归显示，随访时间（p<0.05）、化疗和放疗（p=0.038）是 QM-C 子宫切除术后 MFSI 降低的独立危险因素。②MFSIIA：多因素有序多项逻辑回归显示，随访时间（p<0.05）是 QM-C 子宫切除术后 MFSIIA 降低的独立危险因素。术后 9 个月盆底肌力量（PFMS）较术后 9 个月增加，表明术后 PFMS 可恢复。
我们主张更多关注和重视中国宫颈癌术后女性的盆底肌功能。
目前的研究没有分析 QM-C 子宫切除术后的 PFMF。本研究的贡献在于，根治性子宫切除术患者应在术后 3 个月内进行盆底康复锻炼。本研究的临床研究注册号为 02492542。
