Pelvic floor imaging in women with hemorrhoidal disease: An anatomical feasibility study

IF 2.3 4区医学 Q2 SURGERY

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland Pub Date : 2024-07-09 DOI:10.1016/j.surge.2024.06.006

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引用次数: 0

Abstract

Objective

To compare pelvic floor muscle and organ structures in women with and without hemorrhoidal disease (HD) using magnetic resonance imaging (MRI).

Material and methods

Pelvic MRI measurements and computer-based medical records of women diagnosed with HD between January 2018 and March 2021 were analyzed. Parameters including pubococcygeal distance, puborectal distance, posterior anorectal angle, obturator internus muscle area, presence of levator ani muscle defect, genital hiatus length, vaginal length, uterocervical angle, cervix-upper vagina angle, and cervix-middle vagina angle were evaluated. The control group consisted of women without HD, matched for age and body mass index.

Results

Puborectal hiatus distance was higher in the HD group (59.2 ± 8.7 mm vs. 55.5 ± 7.1 mm, p = 0.03). Similarly, the distance to the M line was greater in the HD group (18.3 ± 4.8 mm vs. 16 ± 4.6 mm, p = 0.04). Obturator internus muscle area was found to be lower in the HD group compared to the non-HD group (1721 ± 291.4 mm² vs. 1897.5 ± 352.5 mm², p = 0.02). Additionally, the presence of unilateral levator ani muscle defect was higher in HD patients (p = 0.03). There was a negative correlation between birthweight and obturator internus muscle area (r = −0.388, p = 0.02), and a positive correlation with M line distance (r = 0.344, p = 0.04).

Conclusion

Levator ani muscle defects and obturator internus muscle area, indicators of pelvic floor dysfunction, are more common in patients with hemorrhoidal disease.

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痔疮妇女的盆底成像：解剖学可行性研究

目的利用磁共振成像（MRI）比较有痔疮（HD）和无痔疮（HD）妇女的盆底肌肉和器官结构：对 2018 年 1 月至 2021 年 3 月期间确诊为 HD 的女性的盆腔 MRI 测量结果和计算机病历进行分析。评估参数包括耻骨尾骨间距、耻骨直肠间距、肛门直肠后角、闭孔肌面积、是否存在提肛肌缺损、生殖器裂隙长度、阴道长度、子宫颈角、子宫颈-阴道上角、子宫颈-阴道中角。对照组由年龄和体重指数相匹配的非 HD 女性组成：结果：HD 组的耻骨直肠间隙距离更大（59.2 ± 8.7 mm 对 55.5 ± 7.1 mm，P = 0.03）。同样，HD 组的 M 线距离也更大（18.3 ± 4.8 mm vs. 16 ± 4.6 mm，p = 0.04）。与非 HD 组相比，HD 组的闭孔肌面积更小（1721 ± 291.4 mm2 vs. 1897.5 ± 352.5 mm2，P = 0.02）。此外，HD 患者出现单侧提肛肌缺损的比例更高（p = 0.03）。出生体重与内收肌面积呈负相关（r = -0.388，p = 0.02），与 M 线距离呈正相关（r = 0.344，p = 0.04）：结论：作为盆底功能障碍的指标，提肛肌缺损和闭孔肌面积在痔疮患者中更为常见。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland 医学-外科

CiteScore

4.40

自引率

0.00%

发文量

158

审稿时长

6-12 weeks

期刊介绍： Since its establishment in 2003, The Surgeon has established itself as one of the leading multidisciplinary surgical titles, both in print and online. The Surgeon is published for the worldwide surgical and dental communities. The goal of the Journal is to achieve wider national and international recognition, through a commitment to excellence in original research. In addition, both Colleges see the Journal as an important educational service, and consequently there is a particular focus on post-graduate development. Much of our educational role will continue to be achieved through publishing expanded review articles by leaders in their field. Articles in related areas to surgery and dentistry, such as healthcare management and education, are also welcomed. We aim to educate, entertain, give insight into new surgical techniques and technology, and provide a forum for debate and discussion.