Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.
Department of Obstetrics and Gynecology, Beaumont Dearborn, 18101 Oakwood Blvd, Dearborn, MI, USA.
Int Urogynecol J. 2022 Dec;33(12):3415-3422. doi: 10.1007/s00192-022-05203-8. Epub 2022 May 3.
The objective was to test the hypotheses that a linear relationship exists between age and levator bowl volume (LBV); and that age, parity, and prolapse are independently associated with LBV.
We conducted a secondary analysis of data from nulliparous women, parous controls, and prolapse (Pelvic Organ Prolapse Quantification (POP-Q) Ba ≥ 1 cm) cases from each of three age groups: young (≤40), mid-age (50-60), and older (≥70). LBV was measured using MRI at rest and Valsalva as the 3D space contained above the levator ani muscles and below the sacrococcygeal junction-to-inferior pubic point reference plane. Linear regression models were used to examine the effects of age, parity, prolapse, and their interactions (ageparity and ageprolapse) on LBV.
Each group consisted of 9-12 women. LBV increased with age in a nonlinear fashion. For nulliparous women, the median value increased 4.7% per decade from the young to mid-age group and 84% per decade from the mid-age to older group; for parous controls, the corresponding increases were 38% and -0.5%; and for women with prolapse, they were 46% and 11%. Age and prolapse status (both p<0.001) were found to be significant independent predictors of LBV. Interactions between ageprolapse (p=0.003) and ageparity (p=0.045) were also independently associated with LBV.
Parity and prolapse influence how age affects LBV. In nulliparous women, age had little effect on LBV until after mid-age. For women with prolapse, LBV increased at a much earlier age, with the biggest difference occurring between young and mid-age women.
本研究旨在检验以下假设：年龄与提肛肌壶腹容积（LBV）之间存在线性关系；年龄、产次和脱垂与 LBV 独立相关。
我们对来自三个年龄组（年轻组[≤40 岁]、中年组[50-60 岁]和老年组[≥70 岁]）的初产妇、经产妇对照组和脱垂（盆腔器官脱垂定量（POP-Q）Ba≥1cm）病例的无产妇数据进行了二次分析。在休息和valsalva 时，使用 MRI 测量 LBV，3D 空间位于提肛肌上方和骶尾骨交界处到耻骨下点参考平面下方。使用线性回归模型检查年龄、产次、脱垂及其相互作用（年龄产次和年龄脱垂）对 LBV 的影响。
每个组包括 9-12 名女性。LBV 随年龄呈非线性增长。对于初产妇，从年轻到中年组，中位数每十年增加 4.7%，从中年到老年组增加 84%；对于经产妇对照组，相应的增加分别为 38%和-0.5%；对于脱垂女性，增加了 46%和 11%。年龄和脱垂状态（均 p<0.001）被发现是 LBV 的显著独立预测因子。年龄脱垂（p=0.003）和年龄产次（p=0.045）之间的相互作用也与 LBV 独立相关。
产次和脱垂影响年龄对 LBV 的影响。在初产妇中，年龄对 LBV 的影响很小，直到中年以后。对于脱垂女性，LBV 在更早的年龄增加，年轻和中年女性之间的差异最大。
