부산대학교 도서관

BACKGROUND:: Women with urgency/frequency predominant lower urinary tract symptoms (UF-LUTS) may have elevated pelvic floor muscle (PFM) position at rest and limited mobility with PFM contraction and bearing down, but this has not been quantified. OBJECTIVES:: To compare PFM position and mobility using transperineal ultrasound (TPUS) at rest, maximal PFM contraction (perineal elevation), and bearing down (perineal descent) in women with and without UF-LUTS. We hypothesized that women with UF-LUTS would demonstrate elevated resting position and decreased excursion of pelvic landmarks during contraction and bearing down as compared with women without UF-LUTS. STUDY DESIGN:: A case-control study METHODS:: Women with UF-LUTS were matched 1:1 on age, body mass index, and vaginal parity with women without UF-LUTS. TPUS videos were obtained during 3 conditions: rest, PFM contraction, and bearing down. Levator plate angle (LPA) and puborectalis length (PR length) were measured for each condition. Paired t tests or Wilcoxon signed rank tests compared LPA and PR length between cases and controls. RESULTS:: Among 21 case-control pairs (42 women), women with UF-LUTS demonstrated greater LPA at rest (66.8°± 13.2° vs 54.9°± 9.8°; P= .006), and less PR lengthening from rest to bearing down (0.2 ± 3.1 mm vs 2.1 ± 2.9 mm; P= .03). CONCLUSION:: Women with UF-LUTS demonstrated more elevated (cranioventral) position of the PFM at rest and less PR muscle lengthening with bearing down. These findings highlight the importance of a comprehensive PFM examination and possible treatment for women with UF-LUTS to include PFM position and mobility.