Correlation of symptoms with location and severity of pelvic organ prolapse
Correlation of symptoms with location and severity of pelvic organ prolapse
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DOI：
10.1067/mob.2001.119078
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发表时间：
2001-12-01
影响因子：
9.8
通讯作者：
Bent, AE
中科院分区：
文献类型：
--
作者：
Ellerkmann, RM;Cundiff, GW;Bent, AE
目标：本研究的目的是比较与盆底功能障碍相关的症状与共存脱垂的位置和严重程度。研究设计：从1998年7月开始的24个月期间，有237名有症状的盆腔器官脱垂的连续患者来到约翰霍普金斯医学中心，并完成了症状-具体的李克特量表问卷，包括标准化的问题，汇编，常用的验证工具。所有的问卷调查都是由患者在看医生之前完成的。进一步的评估包括标准化的体格检查，包括国际尿失禁协会的子宫阴道脱垂分级系统。根据严重程度和相关解剖分区对症状进行分类。与尿失禁和排尿，排便，性功能障碍和盆底功能障碍相关的症状进行了分析，相对于盆腔器官脱垂的位置和严重程度与使用的非参数相关系数，肯达尔的tau-b。结果：女性的平均年龄为57.2岁（范围，23-93岁），109名女性（46%）进行了子宫切除术。总的来说，I I期是最常见的盆腔器官脱垂（51%）。在77名患者（33%）中，前室盆腔器官脱垂占主导地位; 46名患者（19%）表现出后室脱垂，而26名患者（11%）有心尖脱垂。在88例患者（37%）中，没有一个部位比另一个部位更严重，排尿功能障碍的特征是排尿犹豫，延长或间歇性流动，并需要改变位置与前部和顶部盆腔器官脱垂的严重程度增加。盆腔压力和不适沿着脱垂的可视化与盆腔器官脱垂的恶化阶段密切相关。以排便不完全和手指操作为特征的排便功能障碍与后室盆腔器官脱垂恶化相关。性关系受损和禁欲持续时间与盆腔器官脱垂恶化密切相关。一个负相关的盆腔器官脱垂和尿失禁和enuration.Conclusion的严重程度增加之间观察到：女性盆腔器官脱垂的经验，不一定与特定的间隔缺陷的症状。盆腔器官脱垂的严重程度增加与尿失禁和排尿、排便和性功能障碍相关的几种特定症状有弱至中度相关性。
Objective: The purpose of this study was to compare the symptoms that are related to pelvic floor dysfunction with the location and severity of the coexisting prolapse.Study design: Two hundred thirty-seven consecutive patients with symptomatic pelvic organ prolapse came to Johns Hopkins Medicine during a 24-month period beginning in July 1998 and completed a symptom-specific Likert scale questionnaire that included standardized questions that were compiled fro, commonly used validated instruments. All questionnaires were completed by the patients before they were seen by a physician. Further evaluation included a standardized physical examination that included the International Continence Society's system for grading uterovaginal prolapse. Symptoms were categorized according to both severity and associated anatomic compartment. Symptoms that were related to urinary and an al incontinence and voiding, defecatory, sexual, and pelvic floor dysfunction were analyzed with respect to location and severity of pelvic organ prolapse with the use of the nonparametric correlation coefficient, Kendal's tau-b.Results: The mean age of the women was 57.2 years (range, 23-93 years); 109 of the women (46%) had undergone hysterectomy. Overall, stage I I was the most common pelvic organ prolapse (51%) that was encountered. In 77 patients (33%), anterior compartment pelvic organ prolapse predominated; 46 patients (19%) demonstrated posterior compartment prolapse, whereas 26 patients (11%) had apical prolapse. In 88 patients (37%), no single location was more severe than another, Voiding dysfunction that was characterized by urinary hesitancy, prolonged or intermittent flow, and a need to change position was associated with the increasing severity of anterior and apical pelvic organ prolapse. Pelvic pressure and discomfort along with visualization of prolapse were strongly associated with worsening stages of pelvic organ prolapse in all compartments. Defecatory dysfunction characterized by incomplete evacuation and digital manipulation was associated with worsening posterior compartment pelvic organ prolapse. Impairment of sexual relations and duration of abstinence were strongly associated with worsening pelvic organ prolapse. An inverse correlation was observed between increasing severity of pelvic organ prolapse ard urinary incontinence and enuresis.Conclusion: Women with pelvic organ prolapse experience symptoms that do not necessarily correlate with compartment-specific defects. Increasing severity of pelvic organ prolapse is weakly to moderately associated with several specific symptoms that are related to urinary incontinence and voiding, defecatory and sexual dysfunction.