EFFECT OF VAGINAL DELIVERY ON THE PELVIC FLOOR - A 5-YEAR FOLLOW-UP
EFFECT OF VAGINAL DELIVERY ON THE PELVIC FLOOR - A 5-YEAR FOLLOW-UP
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DOI：
10.1002/bjs.1800771213
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发表时间：
1990-12-01
影响因子：
9.6
通讯作者：
HENRY, MM
中科院分区：
文献类型：
--
作者：
SNOOKS, SJ;SWASH, M;HENRY, MM
我们研究了 24 名经产妇女中的 14 名（58%）的盆底肌肉组织及其神经支配，这些妇女被招募参加一项关于分娩对盆底影响的研究，作为 1983 年开始的前瞻性调查的一部分。这 24 名妇女都是在没有产钳辅助的情况下通过阴道途径分娩的。 5 年后，14 人中有 5 人出现了压力性尿失禁的临床症状；其中两人在此期间又进行了一次简单的阴道分娩。 测压和神经生理学证据表明，由于盆底横纹括约肌组织部分去神经支配而导致无力，并伴有阴部神经病变，这在失禁的女性中更为明显。 这些发现为阴道分娩引起的阴部神经病变持续存在并可能随着时间的推移而恶化的假设提供了直接证据。
We have studied the pelvic floor musculature and its innervation in 14 of 24 (58 per cent) multiparous women who had been recruited into a study of the effect of childbirth on the pelvic floor as part of a prospective investigation that began in 1983. These 24 women had all delivered by the vaginal route without forceps assistance. Five of the 14 had developed clinical symptoms of stress incontinence 5 years later; two of them had had a further uncomplicated vaginal delivery during this time. There was manometric and neurophysiological evidence of weakness because of partial denervation of the pelvic floor striated sphincter musculature, with pudendal neuropathy, which was more marked in those women with incontinence. These findings provide direct evidence for the hypothesis that pudendal neuropathy due to vaginal delivery persists and may worsen with time.