Use of Pelvic Floor Ultrasound to Assess Pelvic Floor Muscle Function in Urological Chronic Pelvic Pain Syndrome in Men
Use of Pelvic Floor Ultrasound to Assess Pelvic Floor Muscle Function in Urological Chronic Pelvic Pain Syndrome in Men
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DOI：
10.1111/j.1743-6109.2011.02452.x
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发表时间：
2011-11-01
影响因子：
3.5
通讯作者：
Carrier, Serge
中科院分区：
文献类型：
--
作者：
Davis, Seth N.;Morin, Melanie;Carrier, Serge
导论.泌尿系慢性骨盆疼痛综合征（UCPPS）疼痛的一个重要原因或维持因素可能是骨盆底肌肉（PFM）功能障碍，其也可能与性功能障碍有关并受心理社会因素的影响。盆底超声是一种无创、可靠、相对简单的方法来评估PFM的形态和功能，可以通过肛门直肠角（ARA）和提肌板角（LPA）来评估。本研究的目的是检查与对照组相比，男性UCPPS的PFM形态，并检查疼痛和心理社会措施的相关性。我们的参与者是24名UCPPS男性和26名对照。将GE Voluson E8超声探头放置在会阴上，并在静息和PFM收缩期间拍摄三维图像。主要结局为静息和收缩时的ARA和LPA。参与者还完成了美国国立卫生研究院（NIH）慢性前列腺炎症状指数，男性性健康问卷，状态焦虑量表和疼痛灾难化量表。男性UCPPS有更多的急性ARA比对照组在休息和收缩。两组在休息时LPA没有差异;然而，UCPPS男性在收缩和LP偏移期间有明显更多的锐角。急性ARA与更大的疼痛报告和性功能障碍呈正相关。焦虑与更急性的ARA和更迟钝的LPAs相关。从调查结果中可以得出三个含义。首先，ARA在休息和收缩期间，以及LP角在收缩和LPA偏移与UCPPS的男子从控制分开。第二，在休息和收缩时ARA与疼痛和性功能障碍相关，而休息时LPA与焦虑相关。第三，骨盆底超声有可能成为一种有用的和客观的方法来评估PFM形态在UCPPS。Davis SN，Morin M，Binik YM，Khalife S和Carrier S。应用盆底超声评估男性泌尿系慢性盆腔疼痛综合征患者的盆底肌肉功能。J Sex Med 2011;8：3173-3180.
Introduction. An important cause or maintaining factor for pain in Urological Chronic Pelvic Pain Syndrome (UCPPS) may be pelvic floor muscle (PFM) dysfunction, which may also be implicated in sexual dysfunction and influenced by psychosocial factors. Pelvic floor ultrasound is a noninvasive, reliable, and relatively simple method to assess PFM morphology and function and can be assessed by the anorectal angle (ARA) and levator plate angle (LPA).Aims. The aim of the present study was to examine PFM morphology in men with UCPPS as compared with controls and to examine the correlation with pain and psychosocial measures.Methods. Our participants were 24 men with UCPPS and 26 controls. A GE Voluson E8 ultrasound probe was placed on the perineum, and three-dimensional images were taken at rest and during PFM contraction.Main Outcome Measures. The main outcomes were ARA and LPA at rest and contraction. Participants also completed the National Institute of Health (NIH) Chronic Prostatitis Symptom Index, Male Sexual Health Questionnaire, State Anxiety Inventory, and Pain Catastrophizing Scale.Results. Men with UCPPS had more acute ARAs than controls both at rest and during contraction. The two groups did not differ in LPA at rest; however, men with UCPPS had significantly more acute angles during contraction and LP excursion. Acute ARAs were positively correlated with greater pain report and sexual dysfunction. Anxiety was correlated with more acute ARAs and more obtuse LPAs.Conclusions. Three implications can be drawn from the findings. First, ARA at rest and during contraction as well as LP angle during contraction and LPA excursion separates men with UCPPS from controls. Second, ARA at rest and during contraction was correlated with pain and sexual dysfunction, while LPA at rest was related to anxiety. Third, pelvic floor ultrasound has the potential to be a useful and objective method of assessing PFM morphology in UCPPS. Davis SN, Morin M, Binik YM, Khalife S, and Carrier S. Use of pelvic floor ultrasound to assess pelvic floor muscle function in urological chronic pelvic pain syndrome in men. J Sex Med 2011;8:3173-3180.