Bartolo D C, Roe A M, Mortensen N J
Int J Colorectal Dis. 1986 Apr;1(2):91-5. doi: 10.1007/BF01648413.
It has been suggested that perineal descent causes puborectalis neuropathy. To elucidate this, perineal descent was measured on standard proctograms and prolongation of mean motor unit potential duration was used as the index of denervation of the external sphincter and puborectalis in 9 male and 18 female patients with perineal descent and obstructed defaecation. The findings were compared with 21 normal controls. There was no significant perineal descent below the pubococcygeal line at rest but both males and females had abnormal descent of the anorectal angle on straining and a similar degree of external sphincter neuropathy. Females, however, exhibited a significant degree of puborectalis denervation compared with controls (p less than 0.001) and with male patients (p less than 0.001). Thus external sphincter denervation was associated with perineal descent in both sexes whereas other causes, of which obstetric trauma is a possibility, must be implicated in the puborectalis neuropathy of the females studied.
有人提出会阴下降会导致耻骨直肠肌神经病变。为阐明这一点，对9例男性和18例女性会阴下降且排便梗阻患者进行标准直肠造影测量会阴下降，并将平均运动单位电位时限延长作为外括约肌和耻骨直肠肌去神经支配的指标。将结果与21名正常对照者进行比较。静息时耻骨尾骨线以下无明显会阴下降，但男性和女性在用力时肛管直肠角均有异常下降，且外括约肌神经病变程度相似。然而，与对照组相比（p<0.001）以及与男性患者相比（p<0.001），女性耻骨直肠肌去神经支配程度显著。因此，外括约肌去神经支配在男女两性中均与会阴下降有关，而在所研究女性的耻骨直肠肌神经病变中，其他原因（产科创伤是其中一种可能）必定与之相关。
