The effect of pessary treatment on puborectalis muscle function.
The effect of pessary treatment on puborectalis muscle function.
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子宫托治疗对耻骨直肠肌功能的影响。
DOI：
10.1007/s00192-021-04766-2
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发表时间：
2021-06
影响因子：
1.8
通讯作者：
van der Vaart CH
中科院分区：
文献类型：
--
作者：
Manzini C;van den Noort F;Grob ATM;Withagen MIJ;van der Vaart CH
目的是评估接受子宫托治疗的盆腔器官脱垂（POP）妇女的耻骨直肠肌（PRM）功能是否发生变化。这是一项选择阴道栓治疗的有症状POP女性的前瞻性队列研究。在基线和3个月随访时进行访谈、临床检查和3D/4D经会阴超声检查。使用盆腔器官脱垂定量系统（POPQ）评估POP。基线和随访之间比较的参数为：静息时食管裂孔面积（HArest）、最大收缩（HAactx）和最大Valsalva动作（HAVal）、收缩位移（DISPL-ctx，即，HArest和HAactx之间的相对差异），以及Valsalva中的位移（DISPL-Val，即，HAVal和HArest之间的相对差异）。参数进行了比较，妇女和那些没有完全撕脱。共有162名妇女接受了评估，其中34人被纳入。平均年龄为64岁（SD 11.4），平均BMI为24 kg/m2（SD 3.1）。31名女性患有膀胱膨出，8名女性患有子宫脱垂，12名女性患有后室脱垂。21名女性（61.8%）患有POP II期，13名（38.2%）患有POP III期。最常使用的是环式子宫托（97%）。在整个组中，观察到DISPL-ctx的统计学显著增加（平均差异2.1%，p = 0.017）。在非撕脱组中，HArest和DISPL-ctx显著增加（平均差异分别为4.1%，p = 0.016和2.7%，p = 0.016），DISPL-ctx的增加高于撕脱组（平均差异2.7% vs 0.2%，p = 0.056）。我们的研究结果表明，PRM功能的变化与POP妇女接受阴道栓治疗，并建议这种变化主要发生在没有完全撕脱。
The objective was to assess if puborectalis muscle (PRM) function changes in women with pelvic organ prolapse (POP) undergoing pessary treatment. This was a prospective cohort study of women with symptomatic POP choosing pessary treatment. An interview, clinical examination and 3D/4D transperineal ultrasound were performed at baseline and at 3-month follow-up. POP was assessed using the Pelvic Organ Prolapse Quantification system (POPQ). Parameters compared between baseline and follow-up were: hiatal area at rest (HArest), maximal contraction (HActx), and maximal Valsalva maneuver (HAVal), displacement in contraction (DISPL-ctx, i.e., relative difference between HArest and HActx), and displacement in Valsalva (DISPL-Val, i.e., relative difference between and HAVal and HArest). Parameters were compared in women with and those without complete avulsion. A total of 162 women were assessed and 34 were included. Mean age was 64 years (SD 11.4), and mean BMI 24 kg/m2 (SD 3.1). Thirty-one women had a cystocele, 8 a uterine prolapse, and 12 had a posterior compartment prolapse. Twenty-one women (61.8%) had a POP stage II, and 13 (38.2%) a POP stage III. Ring pessaries were most frequently used (97%). In the entire group a statistically significant increase in DISPL-ctx was observed (mean difference 2.1%, p = 0.017). In the no avulsion group HArest and DISPL-ctx increased significantly (mean difference 4.1%, p = 0.016 and 2.7%, p = 0.016 respectively) and the increase in DISPL-ctx was higher than in the avulsion group (mean difference 2.7% vs 0.2%, p = 0.056). Our results show that PRM function changes in women with POP undergoing pessary treatment and suggest that such change occurs mainly in the absence of complete avulsion.
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影响因子：
1.5
作者：
NORTON, PA
通讯作者：
NORTON, PA
影响因子：
7.2
作者：
Cundiff, GW;Weidner, AC;Addison, WA
通讯作者：
Addison, WA
影响因子：
0.6
作者：
Ritter, Felix;Boskamp, Tobias;Peitgen, Heinz-Otto
通讯作者：
Peitgen, Heinz-Otto
影响因子：
7.2
作者：
Braekken, Ingeborg Hoff;Majida, Memona;Bo, Kari
通讯作者：
Bo, Kari
影响因子：
7.2
作者：
Cheung, Rachel Y. K.;Lee, Jacqueline H. S.;Chan, Symphorosa S. C.
通讯作者：
Chan, Symphorosa S. C.