Pelvic floor disorders following vaginal or cesarean delivery.
Pelvic floor disorders following vaginal or cesarean delivery.
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DOI：
10.1097/gco.0b013e328357628b
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发表时间：
2012-10
影响因子：
2.1
通讯作者：
Handa VL
中科院分区：
文献类型：
--
作者：
Memon H;Handa VL
骨盆底疾病影响所有年龄的妇女，并与重大的经济负担和生活质量差。目前的文献表明，分娩和这些疾病之间的关联。在这篇综述中，我们总结了最近的进展，我们的理解这种关联。阴道分娩似乎与压力性尿失禁和盆腔器官脱垂密切相关。有较少的证据表明阴道分娩和膀胱过度活动症症状之间的关联。有一处以上会阴撕裂伤的病史会增加发生脱垂的可能性。类似的关联尚未建立会阴切开术。骨盆底支持系统的结构部件，特别是提肛肌复合体的破坏或去神经支配与骨盆底疾病的后期发展相关。分娩期间过度拉伸导致的阴道壁结缔组织重塑的稳态失衡是另一种可能的机制。骨盆底疾病是影响所有年龄妇女的一个重大健康问题。识别潜在的可改变的风险因素和了解潜在的病理生理学的进步是至关重要的一级和二级预防这些疾病和改善治疗策略。
Pelvic floor disorders affect women of all ages and are associated with significant economic burden and poor quality of life. Current literature suggests an association between childbirth and these disorders. In this review, we summarize recent advancements in our understanding of this association. Vaginal childbirth appears to be strongly associated with stress urinary incontinence and pelvic organ prolapse. There is less evidence to suggest an association between vaginal delivery and overactive bladder symptoms. History of more than one perineal laceration increases the likelihood of developing prolapse. Similar association has not been established for episiotomy. Disruption or denervation of structural components of pelvic floor support system, particularly levator ani muscle complex, is associated with later development of pelvic floor disorders. Imbalance in homeostasis of connective tissue remodeling of the vaginal wall from overstretching during childbirth is another possible mechanism. Pelvic floor disorders represent a significant health problem affecting women of all ages. Identification of potential modifiable risk factors and advancement in understanding of the underlying pathophysiology is crucial for primary and secondary prevention of these disorders and for improvement in treatment strategies.