Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands.
Neurourol Urodyn. 2022 Nov;41(8):1739-1748. doi: 10.1002/nau.24996. Epub 2022 Jul 25.
Pelvic floor symptoms (PFS), such as lower urinary tract symptoms, defecation disorders, sexual problems, and genital-pelvic pain, are prevalent in men. Thorough physical assessments of the external anal sphincter (EAS) and the puborectal muscle (PRM) are the keys to unraveling the role of muscle dysfunction.
To explore associations within and between the EAS and PRM and between muscle (dys-) function and the number of male PFS.
This cross-sectional study purposively enrolled men aged ≥21 years with 0-4 symptoms from a larger study. After extensive external and internal digital pelvic floor assessment, we explored (1) agreement between muscle function of the EAS versus PRM (using cross tabulation), (2) associations within and between the EAS and PRM (using heatmaps), and (3) associations between muscle function and number of PFS (using a visual presentation [heatmaps] and χ tests).
Overall, 42 out of 199 men (21%) had completely normal muscle function. Sixty-six (33.2%) had no symptoms, of which 53 (80%) had some degree of muscle dysfunction. No clear dose-response relationship existed between muscle (dys-) function and the number of symptoms. The PRM showed both more dysfunction and severer dysfunction than the EAS.
No clear association exists between muscle dysfunction and the number of symptoms, and the absence of PFS does not indicate normal muscle function for all men. Dysfunction levels are highest for the PRM. Further pelvic floor muscle research is warranted in men with PFS.
盆底功能障碍（pelvic floor symptoms，PFS），如下尿路症状、排便障碍、性功能障碍和生殖器-骨盆疼痛，在男性中较为常见。彻底评估肛门外括约肌（external anal sphincter，EAS）和耻骨直肠肌（puborectal muscle，PRM）的体表和体内状况是了解肌肉功能障碍的关键。
探讨 EAS 和 PRM 之间以及它们与肌肉（功能）障碍和男性 PFS 数量之间的相关性。
本横断面研究旨在纳入来自更大研究的年龄≥21 岁、存在 0-4 种 PFS 症状的男性。在广泛的外部和内部数字盆底评估后，我们探索了（1）EAS 与 PRM 的肌肉功能之间的一致性（使用交叉列表），（2）EAS 和 PRM 之间的内在和内在相关性（使用热图），（3）肌肉功能与 PFS 数量之间的相关性（使用视觉呈现[热图]和卡方检验）。
总体而言，199 名男性中有 42 名（21%）完全没有肌肉功能障碍。66 名（33.2%）无症状，但其中 53 名（80%）存在不同程度的肌肉功能障碍。肌肉（功能）障碍与症状数量之间没有明确的剂量反应关系。PRM 显示出比 EAS 更多和更严重的功能障碍。
肌肉功能障碍与症状数量之间没有明确的相关性，没有 PFS 并不意味着所有男性的肌肉功能都正常。PRM 的功能障碍水平最高。有必要对患有 PFS 的男性进行进一步的盆底肌肉研究。
