未生育优秀女运动员尿失禁的相关因素:一项使用动态骨盆磁共振成像和问卷调查数据的探索性横断面研究。

IF 5.9 2区 医学 Q1 UROLOGY & NEPHROLOGY
Journal of Urology Pub Date : 2025-06-01 Epub Date: 2025-01-27 DOI:10.1097/JU.0000000000004455
Zoe S Gan, Karthik Sundaram, Ariana L Smith
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引用次数: 0

摘要

目的:尿失禁(UI)在未产女优秀运动员中很常见,但其潜在的病理生理机制尚不清楚。我们检查了这一人群的泌尿系统症状和相关的盆底解剖和功能,假设患有尿失禁的运动员也会出现老年失禁妇女的盆底症状(如盆底下降和尿道过度活动),以及精英运动的结果,如肌肉肥大。材料和方法:我们对NCAA一级无产女运动员进行了横断面研究,比较有症状(即目前或以前在运动中经历过尿漏)和无症状的运动员。我们评估了人口统计学、运动特征、相关病史(包括运动员短暂进食障碍问卷),并验证了泌尿生殖系统症状问卷(下尿路功能障碍网络症状指数-29;女性泌尿生殖系统疼痛指数)。骨盆检查和动态MRI用于评估骨盆底在休息和最大应变。通过MRI对盆底解剖结构进行评估和分割。结果:29名运动员(11名无症状,18名有症状),人口统计学、运动特征和盆腔检查结果在组间无统计学差异。有症状的运动员有更严重的泌尿系统症状(LURN SI-29中位数为8.5比8.0,P=0.022)和泌尿生殖系统疼痛(GUPI中位数为7比3,P=0.036),更大的尿道横纹括括肌前部厚度(中位数为2.5比1.8 mm, P=0.016)和耻骨直肠肌和提肛肌(中位数为10.3比8.6 mm, P=0.028),更严重的饮食失调(中位数BEDA-Q为7.5比4.5,P=0.022)。结论:在未生育女性优秀运动员的尿失禁中,动态骨盆MRI发现盆底解剖结构的差异,这可能是尿失禁多因素病因的一部分。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Factors Associated With Urinary Incontinence in Nulliparous Female Elite Athletes: An Exploratory, Cross-Sectional Study Using Dynamic Pelvic Magnetic Resonance Imaging and Questionnaire Data.

Purpose: Urinary incontinence (UI) is common in nulliparous female elite athletes, but underlying pathophysiology is inadequately understood. We examined urinary symptoms and associated pelvic floor anatomy and function in this population, hypothesizing that athletes with UI would exhibit pelvic floor findings seen in older incontinent women (eg, pelvic floor descent and urethral hypermobility) and findings attributable to elite sporting such as muscle hypertrophy.

Materials and methods: We performed a cross-sectional study of National Collegiate Athletic Association Division 1 nulliparous female athletes comparing symptomatic (ie, currently or previously experienced urinary leakage during exercise) and asymptomatic athletes. We assessed demographics, sport characteristics, relevant medical history (including Brief Eating Disorder in Athletes Questionnaire) and validated genitourinary symptom questionnaires (Lower Urinary Tract Dysfunction Network Symptom Index-29 and Female Genitourinary Pain Index). Pelvic examination and dynamic MRI were used to assess the pelvic floor at rest and at maximal strain. Pelvic floor anatomic structures were evaluated and segmented by MRI.

Results: Of 29 athletes (11 asymptomatic, 18 symptomatic), demographics, sport characteristics, and pelvic examination findings were not statistically different between groups. Symptomatic athletes had significantly worse urinary symptoms (median Lower Urinary Tract Dysfunction Network Symptom Index-29 8.5 vs 8.0, P = .022) and genitourinary pain (median Genitourinary Pain Index 7 vs 3, P = .036), greater anterior thickness of the striated urethral sphincter muscle (median 2.5 vs 1.8 mm, P = .016) and puborectalis and levator ani muscles (median 10.3 vs 8.6 mm, P = .028), and worse disordered eating (median Brief Eating Disorder in Athletes Questionnaire 7.5 vs 4.5, P = .022).

Conclusions: In nulliparous female elite athletes with UI, dynamic pelvic MRI identified differences in pelvic floor anatomy, which may be part of a multifactorial etiology of UI.

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来源期刊
Journal of Urology
Journal of Urology 医学-泌尿学与肾脏学
CiteScore
11.50
自引率
7.60%
发文量
3746
审稿时长
2-3 weeks
期刊介绍: The Official Journal of the American Urological Association (AUA), and the most widely read and highly cited journal in the field, The Journal of Urology® brings solid coverage of the clinically relevant content needed to stay at the forefront of the dynamic field of urology. This premier journal presents investigative studies on critical areas of research and practice, survey articles providing short condensations of the best and most important urology literature worldwide, and practice-oriented reports on significant clinical observations.
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