Rudavsky Aliza
Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA.
Int Urogynecol J. 2024 Nov;35(11):2159-2170. doi: 10.1007/s00192-024-05949-3. Epub 2024 Oct 9.
Pelvic floor muscle ultrasound is an important clinical tool for improving motor coordination and even strength. Although the gold standard approach involves transperineal probe placement, this is not always feasible with sensitive populations, requires privacy owing to probe placement, and additional sonography training. This article introduces a novel transabdominal method for measuring pelvic floor muscle motion that incorporates a reference point within the bladder. The hypothesis is that the novel measurement will correlate positively with transperineal measurements.
A total of 55 women (15 nulliparous, 40 parous; 20 continent, 35 incontinent) performed pelvic floor muscle contraction and strain. Transabdominal ultrasound measured bladder diagonal length (BDL) and transperineal ultrasound measured bladder neck height (BNH), levator plate length (LPL), and levator plate angle (LPA). Spearman's test measured the correlation between the measurement outcomes and an independent t test compared outcomes based on parity and stress urinary incontinence symptom status.
Spearman's correlation showed moderate positive correlations between the pelvic floor measurements for both tasks, which reduced slightly when grouping by parity and symptom status. Group differences were significant for BDL during the muscle contraction, factoring in SUI symptoms (p = 0.019) and parity status (p = 0.005) and LPL during contraction, factoring in parity status (p = 0.033).
BDL correlates with BNH, LPL, and LPA with slightly reduced correlation when factoring in parity and continence status. The advantages of the method include accessibility for sensitive populations, nontraditional positions due to the anatomical reference point, functional locations due to limited privacy needs, and minimal training required for pelvic floor therapists to incorporate into rehabilitation.
盆底肌肉超声是改善运动协调性和肌肉力量均衡的重要临床工具。尽管金标准方法是经会阴放置探头，但对于敏感人群而言，这并不总是可行的，由于探头放置需要隐私空间，且需要额外的超声检查培训。本文介绍了一种新的经腹测量盆底肌肉运动的方法，该方法在膀胱内纳入了一个参考点。假设是这种新测量方法将与经会阴测量结果呈正相关。
共有55名女性（15名未生育、40名已生育；20名尿控正常、35名尿失禁）进行盆底肌肉收缩和用力动作。经腹超声测量膀胱对角线长度（BDL），经会阴超声测量膀胱颈高度（BNH）、提肌板长度（LPL）和提肌板角度（LPA）。Spearman检验测量测量结果之间的相关性，独立t检验根据产次和压力性尿失禁症状状态比较结果。
Spearman相关性显示，两项任务的盆底测量结果之间存在中度正相关，按产次和症状状态分组时相关性略有降低。在考虑尿失禁症状（p = 0.019）和产次状态（p = 0.005）时，肌肉收缩期间BDL的组间差异显著；在考虑产次状态（p = 0.033）时，收缩期间LPL的组间差异显著。
BDL与BNH、LPL和LPA相关，在考虑产次和尿控状态时相关性略有降低。该方法的优点包括对敏感人群的可及性、由于解剖参考点而具有的非传统体位、由于隐私需求有限而具有的功能位置，以及盆底治疗师将其纳入康复所需的最少培训。
