Department of Obstetrics and Gynaecology, Pelvic Floor Unit, Royal Women's Hospital, 20 Flemington Road, Parkville, Victoria, 3052, Australia.
Department of Pediatrics, University of Nevada Las Vegas, Las Vegas, NV, USA.
Int Urogynecol J. 2023 Jul;34(7):1471-1476. doi: 10.1007/s00192-022-05390-4. Epub 2022 Oct 29.
The relationship between external lumbar, hip, and/or pelvic girdle pain and internal vaginal pelvic floor myofascial pain is not well described. We assessed this relationship in a cohort of adult women.
The cohort included women ≥ 18 years old who received care for external lumbar, hip, and/or pelvic girdle pain (reported or elicited on physical examination) who then underwent internal vaginal myofascial levator ani pain assessments, in a tertiary care Female Pelvic Medicine and Reconstructive Surgery pelvic pain clinic over a 2-year period (2013 and 2014).
The cohort of 177 women had an average age of 44.9±16.0 years, an average body mass index of 27.2±7.0 kg/m, and the majority (79.2%) were white. Most patients presented with a chief complaint of pelvic (51.4%), vulvovaginal (18.6%), and/or lumbar (15.3%) pain. Women who reported symptoms of lumbar, hip, or pelvic girdle pain were more likely to have pain on vaginal pelvic floor muscle examination than women without this history (OR, 7.24; 95% CI, 1.95-26.93, p=0.003). The majority (85.9%) of women had bilateral internal vaginal pelvic floor myofascial pain on examination.
Although participants did not describe "vaginal pelvic floor myofascial pain," the high detection rate for internal vaginal pelvic floor myofascial pain on clinical examination highlights an opportunity to improve treatment planning. These findings suggest that the vaginal pelvic floor muscle examination should be part of the assessment of all women with lumbar, hip, and/or pelvic girdle pain. The relationship between this finding and clinical outcomes following directed treatment warrants additional study.
腰部、臀部和/或骨盆带外部疼痛与内部阴道盆底筋膜疼痛之间的关系尚未得到很好的描述。我们评估了一个成年女性队列中的这种关系。
该队列包括年龄在 18 岁以上的女性，她们因腰部、臀部和/或骨盆带疼痛（体格检查时报告或引出）而接受治疗，然后在 2 年内（2013 年和 2014 年）在三级护理女性盆底医学和重建外科盆腔疼痛诊所接受内部阴道筋膜提肛肌疼痛评估。
177 名女性的队列平均年龄为 44.9±16.0 岁，平均体重指数为 27.2±7.0kg/m，大多数（79.2%）为白人。大多数患者的主要主诉为骨盆（51.4%）、外阴阴道（18.6%）和/或腰部（15.3%）疼痛。报告腰部、臀部或骨盆带疼痛症状的女性比没有这种病史的女性更有可能在阴道盆底肌肉检查时出现疼痛（OR，7.24；95%CI，1.95-26.93，p=0.003）。检查时，大多数（85.9%）女性双侧阴道盆底筋膜均有肌筋膜疼痛。
尽管参与者没有描述“阴道盆底筋膜疼痛”，但在临床检查中内部阴道盆底筋膜疼痛的高检出率突显了改善治疗计划的机会。这些发现表明，阴道盆底肌肉检查应成为所有腰部、臀部和/或骨盆带疼痛女性评估的一部分。针对这种发现进行有针对性治疗后的临床结果之间的关系需要进一步研究。
