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Título: Assessment of pubovisceral muscle defects and levator hiatal dimensions in women with faecal incontinence after vaginal delivery : is there a correlation with severity of symptoms?
Autor(es): Murad-Regadas, Sthela Maria
Fernandes, Graziela Olivia da S.
Regadas, Francisco Sergio Pinheiro
Rodrigues, Lusmar Veras
Pereira, Jacyara de Jesus Rosa
Dealcanfreitas, Iris Daiana
Regadas Filho, Francisco Sergio Pinheiro
Palavras-chave: Diafragma da Pelve
Incontinência Fecal
Data do documento: Dez-2014
Editor: Colorectal Disease
Citação: MURAD-REGADAS, S. M. ; FERNANDES, G. O. S. ; REGADAS, F. S. P. ; RODRIGUES, L. V. ; PEREIRA, J. J. R. ; DELCANFREITAS, I. D. ; REGADAS FILHO, F. S. P. (2014)
Abstract: Aim We assessed pubovisceral muscle (PVM) defects, levator hiatal dimensions and anal sphincter defects using three-dimensional (3D) endovaginal and anorectal ultrasonography in women with previous vaginal delivery and faecal incontinence to determine the relationship between anatomic/functional findings and severity of faecal incontinence symptoms. Method This was a prospective, observational study including 52 women with faecal incontinence symptoms who had undergone vaginal delivery. Asymptomatic nulliparous women (n = 17) served as controls to provide reference values for pelvic floor measurements. All participants underwent 3D endovaginal and anorectal ultrasonography. We used an ultrasound score to identify and quantify the extent of PVM defects and sphincter damage and to measure levator hiatal dimensions. Incontinence was assessed using the Cleveland Clinic Florida Incontinence Scoring System. Results Defects of the PVM were identified with 3D endovaginal ultrasonography in 27% of women with faecal incontinence who had undergone vaginal delivery. The incontinence score and the ultrasound score were significantly higher in women with a PVM defect. A significant, positive correlation was found between the incontinence score and the ultrasound score. The levator hiatal dimensions were significantly greater, and the positions of the anorectal junction and bladder neck were lower, in women who had undergone vaginal delivery than in nulliparous women. Conclusion As determined by the 3D ultrasound score, severity of incontinence is related to the extent of damage of the PVM, as well as of the anal sphincters. Additionally, vaginal delivery results in enlargement of the levator hiatus and a lower position of the anorectal junction and bladder neck compared with nulliparous women.
Descrição: MURAD-REGADAS, S. M. ; FERNANDES, G. O. da S. ; REGADAS, F. S. P. ; RODRIGUES, PEREIRA, L. V. ; PEREIRA, J. de J. R. ; DEALCANFREITAS, I. D. ; REGADAS FILHO, F. S. P. Assessment of pubovisceral muscle defects and levator hiatal dimensions in women with faecal incontinence after vaginal delivery : is there a correlation with severity of symptoms?. Colorectal Disease v. 16, n. 12, p. 1010-18, dez., 2014.
URI: http://www.repositorio.ufc.br/handle/riufc/11036
ISSN: 1463-1318 Online
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