Swift S E, Herring M
Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston 29425, USA.
Obstet Gynecol. 1998 Jun;91(6):961-4. doi: 10.1016/s0029-7844(98)00111-2.
To determine if there is a significant difference in the degree of pelvic organ prolapse assigned during examination in the standing position compared with the dorsal lithotomy position with the patient performing maximal Valsalva maneuver.
Fifty-one women with symptoms of pelvic organ prolapse were examined in both the dorsal lithotomy position, while performing maximal Valsalva, and in the standing position at the same visit by one of two examiners. Nine site-specific measures and summary stages were recorded, as outlined by the International Continence Society's classification system for pelvic organ prolapse. The data were analyzed by Wilcoxon signed-rank test and correlation coefficients.
The mean age was 52 +/- 15 years. Excellent correlation was noted between all six points representing the vaginal prolapse. The R values for point Aa were 0.97, Ba 0.96, C 0.98, Ap 0.97, Bp 0.96, and D 0.97. The total vaginal length, perineal body, and genital hiatus measurements were performed in the dorsal lithotomy position with the patient at rest and were not repeated. The stages were identical in 48 of 51 patients. The average stage in the dorsal lithotomy position was 2.3 and in the standing position, 2.3. There was no statistically significant difference between the stage or any of the measured points in the dorsal lithotomy and standing examinations.
The degree of pelvic organ prolapse can be assessed adequately in the dorsal lithotomy position with the patient performing maximal Valsalva. It is not necessary to routinely repeat the examination in the standing position.
确定在患者进行最大程度瓦尔萨尔瓦动作时，站立位检查与膀胱截石位检查所判定的盆腔器官脱垂程度是否存在显著差异。
51名有盆腔器官脱垂症状的女性在同一次就诊时，由两名检查者之一分别在膀胱截石位（进行最大程度瓦尔萨尔瓦动作时）和站立位进行检查。按照国际尿控协会盆腔器官脱垂分类系统的概述，记录9项特定部位测量值和总体分期。数据采用Wilcoxon符号秩检验和相关系数进行分析。
平均年龄为52±15岁。代表阴道脱垂的所有六个点之间均存在极好的相关性。Aa点的R值为0.97，Ba点为0.96，C点为0.98，Ap点为0.97，Bp点为0.96，D点为0.97。在膀胱截石位患者静息状态下测量了阴道总长度、会阴体和生殖裂孔，未重复测量。51名患者中有48名分期相同。膀胱截石位的平均分期为2.3，站立位为2.3。膀胱截石位和站立位检查在分期或任何测量点之间均无统计学显著差异。
在膀胱截石位让患者进行最大程度瓦尔萨尔瓦动作时，能够充分评估盆腔器官脱垂程度。无需常规在站立位重复检查。
