Li Song, Wen Xuewei, Gao Zhenhua, Ke Kunbin, Yang Jing, Wang Haifeng, Mo Yin, Zeng Yizhen, Li Yuan, Tian Daoming, Shen Jihong
Urology Department, Kunming Medical University First Affiliated Hospital, Kunming, China.
Ophthalmology Department, Kunming Medical University First Affiliated Hospital, Kunming, China.
Front Surg. 2022 Feb 10;9:760723. doi: 10.3389/fsurg.2022.760723. eCollection 2022.
To analyze the role of the axial positions of the uterus and vagina in providing pelvic floor support, encourage evaluations of pelvic floor function, and improve the understanding of the pathogenesis of pelvic organ prolapse.
The lengths and angles of the upper, middle, and lower axes of the vagina, uterine body, and cervix of 81 women with prolapse (prolapse group) and 57 women without prolapse (non-prolapse group) were measured and compared using magnetic resonance images. The pelvic inclination correction system (PICS) line was also compared between the groups. The coordinate parameters of the anatomical points of the uterus and vagina were measured, and their positions were analyzed.
In the prolapse group, the uterine body-cervical angle, cervical-upper vaginal angle, uterine body-PICS line angle, cervical-PICS line angle, and lower vaginal-PICS line angle were smaller ( < 0.05) and the middle-lower vaginal angle, upper vaginal-PICS line angle, and middle vaginal-PICS line angles were larger ( < 0.05) than those in the non-prolapse group. The cervical length was longer ( < 0.05) and the middle and lower vaginal lengths were shorter ( < 0.05) in the prolapse group. The coordinate system revealed that the uterine and vaginal axes were shifted backward and downward in the prolapse group.
Patients in the prolapse group were more likely to have retroversion and retroflexion of the uterus than those in the non-prolapse group. The vagina was shortened, turned forward, and straightened, and the uterus and vagina were shifted backward and downward in the prolapse group. Changes in the axial position of the uterus and vagina are important mechanisms of pelvic floor organ prolapse.
分析子宫和阴道的轴向位置在提供盆底支持方面的作用，鼓励对盆底功能进行评估，并增进对盆腔器官脱垂发病机制的理解。
使用磁共振图像测量并比较81例脱垂女性（脱垂组）和57例无脱垂女性（非脱垂组）的阴道、子宫体和宫颈上、中、下轴的长度和角度。还比较了两组之间的骨盆倾斜校正系统（PICS）线。测量子宫和阴道解剖点的坐标参数，并分析其位置。
与非脱垂组相比，脱垂组的子宫体-宫颈角、宫颈-上阴道角、子宫体-PICS线角、宫颈-PICS线角和下阴道-PICS线角较小（<0.05），而中-下阴道角、上阴道-PICS线角和中阴道-PICS线角较大（<0.05）。脱垂组的宫颈长度较长（<0.05），中、下阴道长度较短（<0.05）。坐标系显示，脱垂组的子宫和阴道轴向后下方移位。
与非脱垂组相比，脱垂组患者子宫后倾和后屈的可能性更大。脱垂组阴道缩短、向前旋转并变直，子宫和阴道向后下方移位。子宫和阴道轴向位置的改变是盆底器官脱垂的重要机制。
