Saraluck Apisith, Aimjirakul Komkrit, Jiet Ng Jun, Chinthakanan Orawee, Mangmeesri Peeranuch, Manonai Jittima
Department of Obstetrics & Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand.
Department of Obstetrics and Gynaecology, Kuala Lumpur Hospital, Jalan Pahang, 50586, Kuala Lumpur, Malaysia.
Arch Gynecol Obstet. 2024 May;309(5):2237-2245. doi: 10.1007/s00404-024-07426-0. Epub 2024 Mar 5.
To investigate the prevalence of DD and AI with POP symptoms in females attending a urogynecology clinic, and to identify factors associated with DD and AI in POP symptoms patients.
Computer-based medical records of women with POP symptoms attending a urogynecology clinic in a referral tertiary center between January 2016 and December 2020 were reviewed. Demographic data were collected. Selected defecatory dysfunction (DD) and anal incontinence (AI) were recorded. The associations between patient characteristics, site and severity of prolapse, and DD and AI symptoms in POP patients were investigated for identified associated factors.
The mean age of the 754 participants was 65.77 ± 9.44 years. Seven hundred and fifteen (94.83%) were menopause. The prevalence of DD and AI in patients with POP symptoms was 44.03% (332/754) and 42.04% (317/754) according to the PFBQ and medical history records, respectively. Advanced posterior wall prolapse (OR 1.59, 95% CI 1.10-2.30) and wider GH (OR1.23, 95% CI 1.05-1.43) were identified as risk factors for DD by multivariate analysis. Additionally, single-compartment prolapse (OR 0.4, 95% CI 0.21-0.76) and a stronger pelvic floor muscle assessed with brink score (OR 0.94, 95% CI 0.88-0.98) are protective factors for AI.
DD and AI are prevalent among women with POP symptoms who visit a urogynecology clinic. DD should be evaluated in women with POP symptoms especially in women with increased genital hiatus and point Ap beyond the hymen. To prevent AI, women with POP should be encouraged to perform pelvic floor muscle training in order to increase pelvic floor muscle strength.
调查在一家泌尿妇科诊所就诊的有盆腔器官脱垂（POP）症状女性中排便障碍（DD）和肛门失禁（AI）的患病率，并确定POP症状患者中与DD和AI相关的因素。
回顾了2016年1月至2020年12月期间在一家三级转诊中心的泌尿妇科诊所就诊的有POP症状女性的计算机化病历。收集了人口统计学数据。记录了选定的排便功能障碍（DD）和肛门失禁（AI）情况。研究了POP患者的患者特征、脱垂部位和严重程度与DD和AI症状之间的关联，以确定相关因素。
754名参与者的平均年龄为65.77±9.44岁。715名（94.83%）处于绝经状态。根据盆底功能问卷（PFBQ）和病史记录，有POP症状患者中DD和AI的患病率分别为44.03%（332/754）和42.04%（317/754）。多因素分析确定后壁重度脱垂（比值比[OR]1.59，95%置信区间[CI]1.10 - 2.30）和较宽的生殖裂孔（OR1.23，95%CI 1.05 - 1.43）是DD的危险因素。此外，单腔脱垂（OR 0.4，95%CI 0.21 - 0.76）和用布林克评分评估的较强盆底肌肉（OR 0.94，95%CI 0.88 - 0.98）是AI的保护因素。
在到泌尿妇科诊所就诊的有POP症状女性中，DD和AI很常见。对于有POP症状的女性，尤其是生殖裂孔增大和处女膜外A点脱垂的女性，应评估其DD情况。为预防AI，应鼓励有POP的女性进行盆底肌肉训练以增强盆底肌肉力量。
