Biomechanical evaluation of pelvic floor muscle function

压力性尿失禁影响全世界七分之一的女性，每年与这种疾病相关的费用超过10亿美元。盆底肌肉的激活被认为是预防尿失禁发作的最重要因素，因为当其他机制失败时，这些肌肉产生的力量有助于关闭尿路。因此，盆底肌肉锻炼通常是治疗失禁障碍的一线治疗方法。然而，这些锻炼并不是在所有情况下都成功，人们对它们成功的机制知之甚少。人们怀疑这种成功与腹部、盆底和尿路压力的适当结合有关，然而，这些压力和产生这些压力的肌肉之间的正常关系目前尚不清楚。这项研究计划旨在提供对女性在暴露于不同功能应激源时的尿动力学和神经生理学的了解。这项工作的目标包括模拟大陆女性在自愿收缩、反射性收缩和Valsalva动作期间记录的腹内、尿道内和阴道内压力上升之间的相互关系，并将这些模式与压力性尿失禁(SUI)女性记录的模式进行比较。以及腹内、在功能性活动中记录的尿道内和阴道内压力以及相关的肌肉激活模式可能为发展不同的训练方法提供证据，这些训练方法针对保守方法治疗女性SUI时的特定运动控制缺陷。

Stress urinary incontinence affects one in seven women worldwide, and annual costs associated with this disorder exceed one billion dollars US.  Activation of the pelvic floor muscles is claimed to be the most important factor in the prevention of incontinence episodes, as the force generated by these muscles assists with closing the urethra when other mechanisms fail.  As such, pelvic floor muscle exercises are often a first line of treatment for incontinence disorders.  These exercises, however, are not successful in all cases and little is known about the mechanisms involved in their success.  It is suspected that this success is related to the proper coupling of abdominal, pelvic floor and urethral pressures, however the normal relationships among these pressures and the muscles involved in generating them are not currently known.  This research proposal is designed to provide an understanding of the urodynamics and neurophysiology of the female continence mechanism when it is exposed to different functional stressors.  The objectives of this work include modelling the inter-relationships among rises in intraabdominal, intraurethral, and intravaginal pressure recorded during voluntary contractions, reflex contractions and valsalva maneuvers in continent women and comparing these patterns to those recorded from women with stress urinary incontinence (SUI).  The correlatation between patterns of intraabdominal, intraurethral and intravaginal pressure recorded during functional activities and the associated patterns of muscle activation may provide evidence for the development of different training approaches which target specific motor control deficits when treating women suffering from SUI by conservative means.