期刊
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
卷 202, 期 5, 页码 -出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.ajog.2010.01.002
关键词
fecal incontinence; levator ani muscle; magnetic resonance imaging; pelvic floor muscle; pelvic organ prolapse; urinary incontinence
资金
- NICHD NIH HHS [U10 HD41263, U10 HD41269, U10 HD41267, UG1 HD054241, U10 HD041250, U10 HD041268, U10 HD041269, U10 HD054136, U10 HD041248, U10 HD041267, U10 HD041263, U10 HD41268, U10 HD41250, U01 HD41249, U10 HD054136-04, U10 HD041261, U01 HD041249, U10 HD41261, U10 HD41248] Funding Source: Medline
OBJECTIVE: The objective of the study was to correlate the presence of major levator ani muscle (LAM) injuries on magnetic resonance imaging (MRI) with fecal incontinence (FI), pelvic organ prolapse (POP), and urinary incontinence (UI) in primiparous women 6-12 months postpartum. STUDY DESIGN: A published scoring system was used to characterize LAM injuries on MRI dichotomously (MRI negative, no/mild vs MRI positive, major). RESULTS: Major LAM injuries were observed in 17 of 89 (19.1%) women who delivered vaginally with external anal sphincter (EAS) injuries, 3 of 88 (3.5%) who delivered vaginally without EAS injury, and 0 of 29 (0%) who delivered by cesarean section before labor (P = .0005). Among women with EAS injuries, those with major LAM injuries trended toward more FI, 35.3% vs 16.7% (P = .10) and POP, 35.3% vs 15.5% (P = .09), but not UI (P = 1.0). CONCLUSION: These data support the growing body of literature suggesting that both EAS and LAM are important for fecal continence and that multiple injuries contribute to pelvic floor dysfunction.
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