Introduction: Pelvic floor muscle function of 30 overweight postmenopausal women prior to and after colporrhahpy was monitored in this study. Material and Methods: Patients diagnosed with cystokele or combined cystore...Introduction: Pelvic floor muscle function of 30 overweight postmenopausal women prior to and after colporrhahpy was monitored in this study. Material and Methods: Patients diagnosed with cystokele or combined cystorectokele was involved. 1 mg oral estriol and local estriol cream were administered for 30 days preoperatively. Pelvic floor muscle function was monitored by surface electromyography 1 month before (1st) 1 day prior to surgery (2nd), and six weeks after the surgery (3rd measurement). Body composition parameters (intra- and extracellular water and body fat) were also measured. Results: The ability to relax significantly improved (p = 0.03) in the preoperative period (between 1st and 2nd occasions). Six weeks after surgery a non-significant (p = 0.054) decrease in average muscle activity was detected when compared with values obtained before the surgery. Muscle-activity declined significantly from the first to the last measurements (p = 0.005). Conclusion: Our results confirm that postmenopausal obese women who undergo anterior or posterior colporrhaphy need a follow-up concerning pelvic floor muscle function and suggest that physiotherapy started the earliest possible may aid in preserving postoperative functionality on the long run.展开更多
AIM: To review of the efficacy and safety outcomes of different single incision slings(SIS) systems, also in comparison with traditional slings.METHODS: A literature search was conducted in Pub Med/MEDLINE database. T...AIM: To review of the efficacy and safety outcomes of different single incision slings(SIS) systems, also in comparison with traditional slings.METHODS: A literature search was conducted in Pub Med/MEDLINE database. The research was restricted to randomized and/or prospective trials and retrospective studies, published after 2006, with at least 20 patients with non-neurogenic stress urinary incontinence(SUI). The studies had to assess efficacy and/or safety of the SIS with a minimum follow-up of 12 mo. All the paper assessing the performance of tension free vaginal tape secur were excluded from this review. The final selection included 19 papers fulfilling the aforementioned criteria. Two authors independently reviewed the selected papers.RESULTS: Four different SIS systems were analysed: Ajust®, Ophira®, Altis® and Mini Arc®. The average objective cure rate was 88%. Overall no statistically significant differences were found between SIS and traditional mid-urethral slings(MUS) in terms of objective cure(all P > 0.005). Only one paper showed a statistically lower success rate in Mini Arc® vs Advantage® slings(40% vs 90%) and higher rates of failure in the SIS group. Since there was a great variability in terms of tests performed, it was not possible to compare subjective cure between studies. The vast part of the studies showed no major complications after SIS surgery. We also observed very low reported pain rates in SIS patients. The RCTs on Ajust® and Mini Arc®, showed better outcomes in terms of post-operative pain compared to MUS. None of the patients reported longterm pain complains.CONCLUSION: SIS showed similar efficacy to that of traditional slings but lower short-term pain, complication and failure rates.展开更多
Objective: To investigate the causes and preventive measures of pelvic floor peritoneal hernia after transabdominal perineal radical resection of rectal cancer. Patients and Methods: A 68-year-old patient with progres...Objective: To investigate the causes and preventive measures of pelvic floor peritoneal hernia after transabdominal perineal radical resection of rectal cancer. Patients and Methods: A 68-year-old patient with progressive exacerbation of Miles’ postoperative intestinal obstruction was retrospectively analyzed. Conservative treatment was ineffective, and surgery was performed again. Surgery confirmed that the obstruction was caused by a pelvic floor peritoneal hernia. The original reconstruction peritoneal suture needle spacing was too wide, resulting in peritoneal hiatus. Results: The early postoperative intestinal obstruction in this patient was not caused by inflammatory intestinal obstruction, stenosis of stoma, and intestinal adhesion, but by the formation of pelvic floor peritoneal hernia. Conclusion: Pelvic floor peritoneal hernia should not be ignored in the early stage of intestinal obstruction after Miles’ operation. Improper suture during pelvic floor peritoneal reconstruction is the main cause of pelvic floor peritoneal hernia.展开更多
Magnetic resonance imaging (MRI) measurements are essential for the diagnosis of pelvic organ prolapse given the inaccuracy of clinical examination. However, MRI pelvic floor measurements are currently performed manua...Magnetic resonance imaging (MRI) measurements are essential for the diagnosis of pelvic organ prolapse given the inaccuracy of clinical examination. However, MRI pelvic floor measurements are currently performed manually and can be inconsistent and time-consuming. In this paper, we present a scheme for semi-automatic measurement modeling on MRI based on image segmentation and intersecting point identification methods. The segmentation algorithm is a multi-stage mechanism based on block grouping, support vector machine classification, morphological operation and prior shape information. Block grouping is achieved by classifying blocks as bone or background based on image texture features. The classified blocks are then used to find the initial segmentation by the first phase morphological opening. Prior shape information is incorporated into the initial segmentation to obtain the final segmentation using registration with the similarity type transformation. After segmentation, points of reference that are used for pelvic floor measurements are identified using morphological skeleton operation. The experiments on the MRI images show that the presented scheme can detect the points of reference on the pelvic floor structure to determine the reference lines needed for the assessment of pelvic organ prolapse. This will lead towards more consistent and faster pelvic organ prolapse diagnosis on dynamic MRI studies, and possible screening procedures for predicting predisposition to pelvic organ prolapse by radiologic evaluation of pelvic floor measurements.展开更多
目的观察悬吊运动训练结合盆底生物反馈电刺激治疗女性压力性尿失禁的临床疗效。方法选择60例2020年1月至2021年6月于湖南中医药大学第一附属医院针灸推拿康复科住院部及门诊就诊的女性压力性尿失禁患者,随机分为观察组和对照组,每组30...目的观察悬吊运动训练结合盆底生物反馈电刺激治疗女性压力性尿失禁的临床疗效。方法选择60例2020年1月至2021年6月于湖南中医药大学第一附属医院针灸推拿康复科住院部及门诊就诊的女性压力性尿失禁患者,随机分为观察组和对照组,每组30例,对照组采用盆底肌生物反馈电刺激,观察组在对照组的基础上结合悬吊运动训练。比较治疗前后两组患者的1 h尿垫试验漏尿量、盆底肌功能、尿失禁生活质量问卷(incontinence quality of life questionnaire,I-QOL)等指标及临床疗效。结果治疗后,两组患者1 h尿垫试验漏尿量较治疗前明显降低(P<0.05),盆底肌功能、I-QOL较治疗前明显提高(P<0.05);且观察组1 h尿垫试验漏尿量低于对照组(P<0.01),盆底肌功能、I-QOL高于对照组(P<0.05)。治疗后,观察组总有效率优于对照组(P<0.05)。结论悬吊运动训练结合盆底生物反馈电刺激治疗能显著改善女性压力性尿失禁患者的盆底肌功能,降低漏尿程度,提高患者生活质量,且优于单纯的盆底肌生物反馈电刺激治疗。展开更多
目的:分析Prolift(Prolift Pelvic Floor)和AMS(AMS Peep Connection Tool)两种盆底修复系统治疗女性盆腔器官脱垂(pelvic organ prolapse,POP)的临床疗效以及并发症的差异。方法:选取南京医科大学附属南京妇幼保健院2010年11月—2013年...目的:分析Prolift(Prolift Pelvic Floor)和AMS(AMS Peep Connection Tool)两种盆底修复系统治疗女性盆腔器官脱垂(pelvic organ prolapse,POP)的临床疗效以及并发症的差异。方法:选取南京医科大学附属南京妇幼保健院2010年11月—2013年6月收治的60例POP患者,随机分为Prolift组和AMS组,Prolift组29例,AMS组31例。比较2组患者的临床疗效和并发症。结果:2组患者的手术时间、术中出血量、术后最高体温、尿管留置时间、残余尿量及住院时间比较差异均无统计学意义(P>0.05);排尿困难、会阴部下腹坠胀、网片暴露、阴道壁膨出等术后并发症在2组患者间差异也无统计学意义(P>0.05),Prolift组患者的疼痛及性生活质量下降的发生率显著高于AMS组(P<0.05)。结论:应用Prolift和AMS两种盆底修复系统治疗POP,均能实现盆底解剖重建和功能恢复,但AMS比Prolift更具优势。展开更多
文摘Introduction: Pelvic floor muscle function of 30 overweight postmenopausal women prior to and after colporrhahpy was monitored in this study. Material and Methods: Patients diagnosed with cystokele or combined cystorectokele was involved. 1 mg oral estriol and local estriol cream were administered for 30 days preoperatively. Pelvic floor muscle function was monitored by surface electromyography 1 month before (1st) 1 day prior to surgery (2nd), and six weeks after the surgery (3rd measurement). Body composition parameters (intra- and extracellular water and body fat) were also measured. Results: The ability to relax significantly improved (p = 0.03) in the preoperative period (between 1st and 2nd occasions). Six weeks after surgery a non-significant (p = 0.054) decrease in average muscle activity was detected when compared with values obtained before the surgery. Muscle-activity declined significantly from the first to the last measurements (p = 0.005). Conclusion: Our results confirm that postmenopausal obese women who undergo anterior or posterior colporrhaphy need a follow-up concerning pelvic floor muscle function and suggest that physiotherapy started the earliest possible may aid in preserving postoperative functionality on the long run.
文摘AIM: To review of the efficacy and safety outcomes of different single incision slings(SIS) systems, also in comparison with traditional slings.METHODS: A literature search was conducted in Pub Med/MEDLINE database. The research was restricted to randomized and/or prospective trials and retrospective studies, published after 2006, with at least 20 patients with non-neurogenic stress urinary incontinence(SUI). The studies had to assess efficacy and/or safety of the SIS with a minimum follow-up of 12 mo. All the paper assessing the performance of tension free vaginal tape secur were excluded from this review. The final selection included 19 papers fulfilling the aforementioned criteria. Two authors independently reviewed the selected papers.RESULTS: Four different SIS systems were analysed: Ajust®, Ophira®, Altis® and Mini Arc®. The average objective cure rate was 88%. Overall no statistically significant differences were found between SIS and traditional mid-urethral slings(MUS) in terms of objective cure(all P > 0.005). Only one paper showed a statistically lower success rate in Mini Arc® vs Advantage® slings(40% vs 90%) and higher rates of failure in the SIS group. Since there was a great variability in terms of tests performed, it was not possible to compare subjective cure between studies. The vast part of the studies showed no major complications after SIS surgery. We also observed very low reported pain rates in SIS patients. The RCTs on Ajust® and Mini Arc®, showed better outcomes in terms of post-operative pain compared to MUS. None of the patients reported longterm pain complains.CONCLUSION: SIS showed similar efficacy to that of traditional slings but lower short-term pain, complication and failure rates.
文摘Objective: To investigate the causes and preventive measures of pelvic floor peritoneal hernia after transabdominal perineal radical resection of rectal cancer. Patients and Methods: A 68-year-old patient with progressive exacerbation of Miles’ postoperative intestinal obstruction was retrospectively analyzed. Conservative treatment was ineffective, and surgery was performed again. Surgery confirmed that the obstruction was caused by a pelvic floor peritoneal hernia. The original reconstruction peritoneal suture needle spacing was too wide, resulting in peritoneal hiatus. Results: The early postoperative intestinal obstruction in this patient was not caused by inflammatory intestinal obstruction, stenosis of stoma, and intestinal adhesion, but by the formation of pelvic floor peritoneal hernia. Conclusion: Pelvic floor peritoneal hernia should not be ignored in the early stage of intestinal obstruction after Miles’ operation. Improper suture during pelvic floor peritoneal reconstruction is the main cause of pelvic floor peritoneal hernia.
文摘Magnetic resonance imaging (MRI) measurements are essential for the diagnosis of pelvic organ prolapse given the inaccuracy of clinical examination. However, MRI pelvic floor measurements are currently performed manually and can be inconsistent and time-consuming. In this paper, we present a scheme for semi-automatic measurement modeling on MRI based on image segmentation and intersecting point identification methods. The segmentation algorithm is a multi-stage mechanism based on block grouping, support vector machine classification, morphological operation and prior shape information. Block grouping is achieved by classifying blocks as bone or background based on image texture features. The classified blocks are then used to find the initial segmentation by the first phase morphological opening. Prior shape information is incorporated into the initial segmentation to obtain the final segmentation using registration with the similarity type transformation. After segmentation, points of reference that are used for pelvic floor measurements are identified using morphological skeleton operation. The experiments on the MRI images show that the presented scheme can detect the points of reference on the pelvic floor structure to determine the reference lines needed for the assessment of pelvic organ prolapse. This will lead towards more consistent and faster pelvic organ prolapse diagnosis on dynamic MRI studies, and possible screening procedures for predicting predisposition to pelvic organ prolapse by radiologic evaluation of pelvic floor measurements.
文摘目的观察悬吊运动训练结合盆底生物反馈电刺激治疗女性压力性尿失禁的临床疗效。方法选择60例2020年1月至2021年6月于湖南中医药大学第一附属医院针灸推拿康复科住院部及门诊就诊的女性压力性尿失禁患者,随机分为观察组和对照组,每组30例,对照组采用盆底肌生物反馈电刺激,观察组在对照组的基础上结合悬吊运动训练。比较治疗前后两组患者的1 h尿垫试验漏尿量、盆底肌功能、尿失禁生活质量问卷(incontinence quality of life questionnaire,I-QOL)等指标及临床疗效。结果治疗后,两组患者1 h尿垫试验漏尿量较治疗前明显降低(P<0.05),盆底肌功能、I-QOL较治疗前明显提高(P<0.05);且观察组1 h尿垫试验漏尿量低于对照组(P<0.01),盆底肌功能、I-QOL高于对照组(P<0.05)。治疗后,观察组总有效率优于对照组(P<0.05)。结论悬吊运动训练结合盆底生物反馈电刺激治疗能显著改善女性压力性尿失禁患者的盆底肌功能,降低漏尿程度,提高患者生活质量,且优于单纯的盆底肌生物反馈电刺激治疗。
文摘目的探讨产后盆底功能障碍(postpartum pelvic floor dysfunction,PFD)患者康复治疗效果的影响因素,并构建预测PFD康复效果的列线图模型。方法选取2020年4月至2022年4月徐州医科大学附属淮安医院和淮安市妇幼保健院收治的384例PFD患者为研究对象,患者均行生物反馈电刺激治疗及Kegal训练。治疗后3个月判定患者康复效果并分为康复良好组(n=311)和康复不佳组(n=73)。通过多因素Logistic回归分析筛查出影响PFD患者康复效果的危险因素,利用R 3.6.1软件建立预测PFD康复效果的列线图模型。采用受试者操作特征(receiver operator characteristic,ROC)曲线对模型的预测效能予以评估,并进行H-L拟合优度检验。结果384例患者中,康复不佳73例(19.01%)。康复良好组和康复不佳组高龄孕妇比例、产前体质量指数(body mass index,BMI)、产次、新生儿出生体质量、盆底肌分级、压力性尿失禁(stress urinary incontinence,SUI)程度分级、Kegel训练依从性比较,差异均有统计学意义(P值均<0.05)。多因素Logistic回归分析结果显示,影响PFD康复效果的主要因素为产前BMI(OR=1.741,95%CI:1.284~2.360,P<0.001)、产次≥2次(OR=2.229,95%CI:1.412~7.385,P=0.005)、新生儿出生体质量(OR=2.688,95%CI:1.278~8.635,P<0.001)、盆底肌分级≤1级(1级:OR=2.223,95%CI:1.663~8.349,P=0.040;0级:OR=3.223,95%CI:1.056~9.840,P=0.001)、Kegel训练依从性差(OR=3.092,95%CI:1.726~9.699,P=0.001)。上述5项影响因素的列线图模型曲线下面积(area under the curve,AUC)为0.853(95%CI:0.794~0.912)。拟合优度H-L检验提示,该模型预测PFD患者康复效果的区分度和一致度均较高(χ^(2)=0.837,P=0.416)。结论基于产前BMI、产次≥2次、新生儿出生体质量、盆底肌分级≤1级、Kegel训练依从性等5项影响因素构建的列线图预测模型预测PFD患者康复治疗效果的效能较强。
文摘目的:分析Prolift(Prolift Pelvic Floor)和AMS(AMS Peep Connection Tool)两种盆底修复系统治疗女性盆腔器官脱垂(pelvic organ prolapse,POP)的临床疗效以及并发症的差异。方法:选取南京医科大学附属南京妇幼保健院2010年11月—2013年6月收治的60例POP患者,随机分为Prolift组和AMS组,Prolift组29例,AMS组31例。比较2组患者的临床疗效和并发症。结果:2组患者的手术时间、术中出血量、术后最高体温、尿管留置时间、残余尿量及住院时间比较差异均无统计学意义(P>0.05);排尿困难、会阴部下腹坠胀、网片暴露、阴道壁膨出等术后并发症在2组患者间差异也无统计学意义(P>0.05),Prolift组患者的疼痛及性生活质量下降的发生率显著高于AMS组(P<0.05)。结论:应用Prolift和AMS两种盆底修复系统治疗POP,均能实现盆底解剖重建和功能恢复,但AMS比Prolift更具优势。
