Weber A M, Walters M D, Ballard L A, Booher D L, Piedmonte M R
Department of Gynecology and Obstetrics and the Department of Biostatistics and Epidemiology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Am J Obstet Gynecol. 1998 Dec;179(6 Pt 1):1446-9; discussion 1449-50. doi: 10.1016/s0002-9378(98)70008-0.
This study's objectives were to describe symptoms related to bowel dysfunction in women with uterovaginal prolapse and to compare these symptoms according to extent of posterior vaginal prolapse.
One hundred forty-three women completed a questionnaire assessment of bowel function and underwent standardized physical examination according to the International Continence Society's system for grading uterovaginal prolapse.
The mean age was 59.2 years (SD 11.8 years); 78% of the women were postmenopausal. According to the furthest extent of posterior vaginal prolapse at point Bp, 22 (15.5%) were in stage 0, 46 (32.4%) were in stage I, 50 (35.2%) were in stage II, 23 (16.2%) were in stage III, and 1 (0.7%) was in stage IV. Ninety-two percent of women reported having bowel movements at least every other day. When asked whether straining was required for them to have a bowel movement, 38 (26.6%) reported never or rarely, 71 (49.6%) reported sometimes, 20 (14.0%) reported usually, and 14 (9.8%) reported always. When asked whether they ever needed to help stool come out by pushing with a finger in the vagina or rectum, 98 (69.0%) reported never or rarely, 30 (21.1%) reported sometimes, 8 (5.6%) reported usually, and 6 (4.2%) reported always. Twenty-three women (16.1%) had fecal incontinence, with 11 having loss of control of stool less often than once a month and 12 having it more often than once a month. When asked whether to rate how much they were bothered by their bowel function on a scale of 1 to 10, with 1 being not at all and 10 being extremely, 51.7% of women chose 1 to 4, 20.3% chose 5 to 7, and 28% chose >/=8. There were no clinically significant associations between any of the questions related to bowel function and severity of posterior vaginal prolapse.
Women with uterovaginal prolapse frequently have symptoms related to bowel dysfunction, but this is not associated with the severity of posterior vaginal prolapse.
本研究的目的是描述子宫阴道脱垂女性肠道功能障碍相关症状，并根据阴道后壁脱垂程度比较这些症状。
143名女性完成了肠道功能问卷评估，并根据国际尿失禁协会的子宫阴道脱垂分级系统接受了标准化体格检查。
平均年龄为59.2岁（标准差11.8岁）；78%的女性已绝经。根据阴道后壁脱垂在Bp点的最远距离，22名（15.5%）处于0期，46名（32.4%）处于I期，50名（35.2%）处于II期，23名（16.2%）处于III期，1名（0.7%）处于IV期。92%的女性报告至少每隔一天排便一次。当被问及排便时是否需要用力时，38名（26.6%）报告从不或很少需要，71名（49.6%）报告有时需要，20名（14.0%）报告通常需要，14名（9.8%）报告总是需要。当被问及是否曾需要用手指在阴道或直肠内推挤来帮助粪便排出时，98名（69.0%）报告从不或很少需要，30名（21.1%）报告有时需要，8名（5.6%）报告通常需要，6名（4.2%）报告总是需要。23名女性（16.1%）有大便失禁，其中11名每月大便失控少于一次，12名每月大便失控多于一次。当被问及是否按照1至10分的量表对肠道功能给自己造成的困扰程度进行评分，1分为完全没有困扰，10分为极其困扰时，51.7%的女性选择了1至4分，20.3%的女性选择了5至7分，28%的女性选择了≥8分。与肠道功能相关的任何问题与阴道后壁脱垂严重程度之间均无临床显著关联。
子宫阴道脱垂女性常有肠道功能障碍相关症状，但这与阴道后壁脱垂严重程度无关。
