Background

Pelvic floor muscle function has been shown to be inversely associated with pelvic organ prolapse in Western women, however differences have been documented between ethnic groups.

Objective

To determine if pelvic floor muscle strength and thickness and hiatal area are associated with pelvic organ prolapse in Nepali women.

Methods

This cross-sectional study included non-pregnant Nepali women ≥18 years attending an outpatient gynecology clinic in Kathmandu, Nepal. A clinical examination included the pelvic organ prolapse quantification (POP-Q)- system examination and Modified Oxford Scale. Puborectalis muscle thickness and hiatal area were assessed using 3D/4D translabial ultrasound. Statistical analysis included Pearson's correlation and multiple regression (p < 0.05).

Results

Of the 123 women; 14 (11%) had POP-Q stage 0 prolapse, 29 (24%) stage I, 69 (56%) stage II, 8 (7%) stage III, and 3 (2%) stage IV. Mean ± SD Modified Oxford Scale was 3.37 ± 0.48 and muscle thickness was 1.14 ± 0.21 cm, hiatal area at rest was 14.67 ± 3.11 cm² and on contraction was 11.29 ± 2.51 cm². No associations were found between pelvic floor muscle strength or thickness and POP-Q stages 0–IV. There was a positive correlation found between hiatal area at rest and pelvic organ prolapse stage (r = 0.34, p < 0.001)and hiatal area on contraction and prolapse stage (r = 0.30, p < 0.001) and a negative correlation between pelvic floor muscle strength and hiatal area on contraction (r = −0.36, p < 0.001).

Conclusion

In contrast to previous findings, pelvic floor muscle strength and thickness are not associated with pelvic organ prolapse in this sample of Nepali women. It is important to consider these findings when developing pelvic organ prolapse treatment and management strategies in this population.

中文翻译：

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盆底肌肉力量和厚度是否与尼泊尔女性的盆腔器官脱垂有关？– 横断面研究

背景

在西方女性中，盆底肌肉功能与盆腔器官脱垂呈负相关，但不同种族之间存在差异。

客观的

确定骨盆底肌肉力量和厚度以及裂孔面积是否与尼泊尔女性的盆腔器官脱垂有关。

方法

这项横断面研究包括在尼泊尔加德满都的妇科门诊就诊的 18 岁以上未怀孕的尼泊尔妇女。临床检查包括盆腔器官脱垂定量 (POP-Q) 系统检查和改良牛津量表。使用 3D/4D 经唇超声评估耻骨直肠肌厚度和裂孔面积。统计分析包括 Pearson 相关性和多元回归 ( p  <  0.05)。

结果

在 123 名女性中；14 (11%) 名患有 POP-Q 0 期脱垂，29 (24%) 名 I 期，69 (56%) II 期，8 (7%) III 期和 3 (2%) IV 期。平均 ±  SD 修正牛津量表为 3.37  ±  0.48，肌肉厚度为 1.14  ±  0.21  cm，休息时裂孔面积为 14.67  ±  3.11  cm ²，收缩时为 11.29  ±  2.51  cm ²。未发现盆底肌肉力量或厚度与 POP-Q 0-IV 期之间存在关联。静息时裂孔面积与盆腔器官脱垂阶段呈正相关（r  =  0.34，p  < 0.001) 和收缩和脱垂阶段的裂孔面积 ( r  =  0.30, p  <  0.001) 以及盆底肌肉力量和收缩时裂孔面积之间的负相关 ( r  =  -0.36, p  <  0.001)。

结论

与之前的研究结果相反，在尼泊尔女性样本中，盆底肌肉力量和厚度与盆腔器官脱垂无关。在该人群中制定盆腔器官脱垂治疗和管理策略时，考虑这些发现很重要。