Martan A, Halaska M, Drbohlav P, Voigt R
I. gynekologicko-porodnická klinika 1. LF UK, Praha.
Ceska Gynekol. 1994 Jun;59(3):121-4.
It was repeatedly reported that training of pelvic floor muscles in the treatment of the stress type of urinary incontinence produced favourable results [1, 4, 6, 7, 8, 10]. The objective of the present study was to examine by ultrasound, using the transperineal route, the influence of exercise of pelvic floor muscles in the treatment of the stress type of incontinence on the position of the internal reproductive organs and the vesicourethral system. For exercise and strengthening of the muscles of the pelvic floor the intravaginal aid Kolpexin [7] was used. The authors investigated two parameters--the angle formed by the median axis of the symphysis with the imaginary line connecting the apex of the lower margin of the symphysis with the urethrovesical junction (angle U). The second parameter is the distance of the apex of the lower margin of the symphysis from the urethrovesical junction (line P). The authors recorded statistically significant changes of angle U before and after exercise of the pelvic floor muscles which were confirmed by ultrasonic examination. Changes in the length of line P were not statistically significant. Strengthening of the pelvic floor muscles was confirmed also by manometric examination. From a group of 20 patients 14 (70%) improved markedly after two months' exercise of the pelvic floor muscles and thus are free from complaints. Ultrasonic urogynaecological examination provides information on a change in the position of internal reproductive organs and the vesicourethral system and is one of the many methods which can confirm the effect of conservative or surgical treatment.
多次有报道称，盆底肌肉训练在治疗压力性尿失禁方面取得了良好效果[1,4,6,7,8,10]。本研究的目的是通过经会阴途径超声检查，探讨盆底肌肉锻炼对压力性尿失禁治疗中内生殖器官和膀胱尿道系统位置的影响。为锻炼和增强盆底肌肉，使用了阴道内辅助器具Kolpexin[7]。作者研究了两个参数——耻骨联合中轴线与连接耻骨联合下缘顶点和尿道膀胱交界处的假想线所形成的角度（角度U）。第二个参数是耻骨联合下缘顶点到尿道膀胱交界处的距离（线P）。作者记录了盆底肌肉锻炼前后角度U的统计学显著变化，这一变化经超声检查得到证实。线P长度的变化无统计学意义。压力测定检查也证实了盆底肌肉得到了增强。在一组20名患者中，14名（70%）在进行两个月的盆底肌肉锻炼后明显改善，因此不再有不适症状。超声泌尿妇科检查提供了内生殖器官和膀胱尿道系统位置变化的信息，是众多能够证实保守治疗或手术治疗效果的方法之一。
