Influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions
Influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions
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DOI：
10.1590/s0004-28032011000400009
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发表时间：
2011-12-01
影响因子：
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通讯作者：
Dealcanfreitas, Íris Daiana
中科院分区：
文献类型：
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作者：
Murad-Regadas, Sthela Maria;Regadas, Francisco Sergio P;Dealcanfreitas, Íris Daiana
背景——阴道分娩、年龄和涉及排便梗阻的盆底功能障碍之间的相关性仍然存在争议。目的 - 确定年龄、分娩方式和产次对排便梗阻综合征女性后盆底功能障碍患病率的影响。方法 - 使用动态 3D 超声检查对 469 名患有排便阻塞综合征的女性进行回顾性评估，以量化后盆底功能障碍（直肠前突 II 级或 III 级、直肠套叠、耻骨直肠肌反常收缩/不松弛和肠/乙状结肠前突 III 级）。此外，还评估了括约肌损伤。根据年龄（50 岁）对患者进行分组，并根据分娩方式和产次进行分层：I 组（50 岁）：251 名患者，其中 60 名未产妇，148 名阴道分娩，43 名仅剖腹产。此外，患者根据阴道分娩次数进行分层：0 - 未产妇 (n = 135)，1 - 阴道分娩 (n = 46)，>1 - 阴道分娩 (n = 166)。结果 - II 级或 III 级直肠前突、肠套叠、直肠前突 + 肠套叠和括约肌损伤在 II 组中更为常见 (P = 0.0432；P = 0.0028；P = 0.0178；P = 0.0001)。分层组（未产妇、阴道分娩和剖腹产）在每个年龄组的直肠前突、肠套叠或肛门畸形方面没有显着差异。肠/乙状结肠膨出在阴道组 50 岁中更为普遍。未发现直肠前突与阴道分娩次数之间存在相关性。结论 - 较高年龄（> 50 岁）会影响女性显着直肠前突、肠套叠和括约肌损伤的患病率。然而，分娩方式和产次与排便梗阻女性的直肠前突、肠套叠和肛门异位的患病率无关。
Context - The correlation between vaginal delivery, age and pelvic floor dysfunctions involving obstructed defecation is still a matter of controversy. Objectives - To determine the influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions in women with obstructed defecation syndrome. Methods - Four hundred sixty-nine females with obstructed defecation syndrome were retrospectively evaluated using dynamic 3D ultrasonography to quantify posterior pelvic floor dysfunctions (rectocele grade II or III, rectal intussusception, paradoxical contraction/non-relaxation of the puborectalis and entero/sigmoidocele grade III). In addition, sphincter damage was evaluated. Patients were grouped according to age (50y) and stratified by mode of delivery and parity: group I (50y): 251 patients, 60 nulliparous, 148 vaginal delivery and 43 only caesarean section. Additionally, patients were stratified by number of vaginal deliveries: 0 - nulliparous (n = 135), 1 - vaginal (n = 46), >1 - vaginal (n = 166). Results - Rectocele grade II or III, intussusception, rectocele + intussusception and sphincter damage were more prevalent in Group II (P = 0.0432; P = 0.0028; P = 0.0178; P = 0.0001). The stratified groups (nulliparous, vaginal delivery and cesarean) did not differ significantly with regard to rectocele, intussusception or anismus in each age group. Entero/sigmoidocele was more prevalent in the vaginal group 50y. No correlation was found between rectocele and the number of vaginal deliveries. Conclusion - Higher age (>50 years) was shown to influence the prevalence of significant rectocele, intussusception and sphincter damage in women. However, delivery mode and parity were not correlated with the prevalence of rectocele, intussusception and anismus in women with obstructed defecation.