1.Multivariate analysis for pelvic floor dysfunction.
Yingjie BAO ; Mengcai HU ; Guixiang GAO ; Jie HUANG ; Zhihong ZHANG
Journal of Central South University(Medical Sciences) 2015;40(11):1229-1233
OBJECTIVE:
To investigate the risky factors for pelvic floor functional disorder.
METHODS:
A total of 346 patients, who undergone surgery for pelvic floor reconstruction from January 2007 to December 2013 in the Third Affiliated Hospital of Zhengzhou University, were enrolled for this study and served as an experimental group. Meanwhile, 349 female healthy subjects were selected as a control group. The data including the times of gestation and parity, history of menopause, hysterectomy surgery, uterine fibroid and leucorrhea were recorded.
RESULTS:
Compared with the controls, the numbers of people with hysterectomy, menopause and clean vagina≥III degree, lack of lactobacillus as well as the times of gestation and parity in the experimental group were significantly increased (P<0.05). The history of hysterectomy, the times of gestation and parity and lack of lactobacillus in vagina were the independent risk factors of pelvic floor dysfunction.
CONCLUSION
The history of hysterectomy, the times of gestation and parity, and clean vagina may involve in the occurrence and development of pelvic floor functional disorder, and the existence of lactobacillus in the vagina might be a protective factor.
Case-Control Studies
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Female
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Humans
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Hysterectomy
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Lactobacillus
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isolation & purification
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Menopause
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Multivariate Analysis
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Parity
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Pelvic Floor
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physiopathology
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Pelvic Floor Disorders
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physiopathology
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Pregnancy
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Risk Factors
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Vagina
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microbiology
2.Noxious electrical stimulation of the pelvic floor and vagina induces transient voiding dysfunction in a rabbit survival model of pelvic floor dystonia.
Amy D DOBBERFUHL ; Sara SPETTEL ; Catherine SCHULER ; Robert M LEVIN ; Andrew H DUBIN ; Elise J B DE
Korean Journal of Urology 2015;56(12):837-844
PURPOSE: Existing data supports a relationship between pelvic floor dysfunction and lower urinary tract symptoms. We developed a survival model of pelvic floor dysfunction in the rabbit and evaluated cystometric (CMG), electromyographic (EMG) and ambulatory voiding behavior. MATERIALS AND METHODS: Twelve female adult virgin rabbits were housed in metabolic cages to record voiding and defecation. Anesthetized CMG/EMG was performed before and after treatment animals (n=9) received bilateral tetanizing needle stimulation to the pubococcygeous (PC) muscle and controls (n=3) sham needle placement. After 7 days all animals were subjected to tetanizing transvaginal stimulation and CMG/EMG. After 5 days a final CMG/EMG was performed. RESULTS: Of rabbits that underwent needle stimulation 7 of 9 (78%) demonstrated dysfunctional CMG micturition contractions versus 6 of 12 (50%) after transvaginal stimulation. Needle stimulation of the PC musculature resulted in significant changes in: basal CMG pressure, precontraction pressure change, contraction pressure, interval between contractions and postvoid residual; with time to 3rd contraction increased from 38 to 53 minutes (p=0.008 vs. prestimulation). Vaginal noxious stimulation resulted in significant changes in: basal CMG pressure and interval between contractions; with time to 3rd contraction increased from 37 to 46 minutes (p=0.008 vs. prestimulation). Changes in cage parameters were primarily seen after direct needle stimulation. CONCLUSIONS: In a majority of animals, tetanizing electrical stimulation of the rabbit pelvic floor resulted in voiding changes suggestive of pelvic floor dysfunction as characterized by a larger bladder capacity, longer interval between contractions and prolonged contraction duration.
Animals
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Disease Models, Animal
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Dystonia/*etiology
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Electric Stimulation/adverse effects/methods
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Electromyography/methods
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Female
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Muscle Contraction/physiology
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Pelvic Floor/*physiopathology
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Pelvic Floor Disorders/*complications/physiopathology
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Rabbits
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Urinary Bladder/physiopathology
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Urinary Retention/*etiology
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Urination/physiology
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Urine
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Vagina/*physiopathology
3.Risk Factors of Voiding Dysfunction and Patient Satisfaction After Tension-free Vaginal Tape Procedure.
Sungchan PARK ; Bumsik HONG ; Kyu Sung LEE ; Myung Soo CHOO
Journal of Korean Medical Science 2005;20(6):1006-1010
This study was undertaken to identify risk factors for postoperative voiding dysfunction and factors having impact on patient global satisfaction after a tension-free vaginal tape (TVT) procedure. Two hundred and eighty-five women who underwent the TVT procedure for stress urinary incontinence were analyzed to identify risk factors predictive of voiding dysfunction. Postoperative voiding dysfunction was defined as a peak urinary flow rate (PFR) <10 mL/sec (straining voiding, n=17) or residual urine volume >30% of bladder capacity (incomplete emptying, n=13). The global satisfaction rate was 91.6%. Voiding dysfunction developed in 29 (10.2%) patients. Among the factors, PFR was only factor of significance for voiding dysfunction. There was no significant difference between patients with and without voiding dysfunction in terms of their satisfaction. But postoperative PFR <10 mL/sec significantly compromised global satisfaction after the surgery. In those patients with a preoperative PFR <20 mL/sec, there were more patients with postoperative PFR <10 mL/sec. Peak urinary flow rate is an important factor for the postoperative voiding dysfunction. The inevitable decline in PFR can compromise patients' satisfaction with the procedure, when their postoperative PFR was <10 mL/sec.
Adult
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Aged
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Aged, 80 and over
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Female
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Humans
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Middle Aged
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Patient Satisfaction
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Risk Factors
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Surgical Procedures, Minimally Invasive/methods
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Urinary Incontinence, Stress/*physiopathology/psychology/*surgery
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Urologic Surgical Procedures/methods
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Vagina/surgery
4.Clinical study of Jiawei Bazhen decoction combined with oxytocin for cervical ripening of qi and blood deficiency type of pregnant women.
Xiao-yan KE ; Bao-yan CHEN ; Hui-fang XU ; Dao-cheng LI ; Yan-fang LI ; Xue SUN
China Journal of Chinese Materia Medica 2015;40(9):1821-1824
To study preliminarily the effect of Jiawei Bazhen decoction combined with oxytocin in promoting cervical ripening of full-term pregnancy women who were in the deficiency of qi and blood type through the syndrome differentiation of traditional Chinese medicine (TCM). 180 patients that met the inclusion criteria of the study were randomly divided into three groups: the control group(oxytocin group), the treatment group (Jiawei Bazhen decoction combined with oxytocin group), the blank control group (expected and observation group). Cervical maturity score (Bishop score), vaginal and cervical secretions fetal fibronectin (FFN), the result of induced labor, the result of mother and baby were observed in each group before and after treatment. The result comes out that the cervical Bishop score of pregnant women for treatment group were significantly higher than the control group and blank control group after treatment (P < 0.05). The FFN of pregnant women for the treatment group were significantly different from the control group and blank control group after treatment (P < 0.05). The pregnancy outcome of the three groups: the labor rate and rate of vaginal delivery of the treatment group were higher than the other two groups, and the difference was statistically significant (P < 0.05). The cesarean section rate of the treatment group was significantly lower than the other two groups, the difference was also statistically significant (P < 0.05). The three groups did not appear the phenomenon of neonatal asphyxia. Jiawei Bazhen decoction combined with oxytocin is effective in producing cervical ripening and induce labor. It is convenient, safe and reliable, for it is no obvious adverse effects on mother and fetus, but effective in reducing the rate of cesarean section, and playing a positive role in promoting natural delivery.
Adult
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Cervical Ripening
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drug effects
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metabolism
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Drug Therapy, Combination
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Drugs, Chinese Herbal
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administration & dosage
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Female
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Fibronectins
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secretion
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Humans
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Labor, Induced
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Oxytocin
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administration & dosage
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Pregnancy
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Pregnancy Complications
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drug therapy
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metabolism
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physiopathology
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Pregnancy Outcome
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Qi
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Vagina
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drug effects
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secretion
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Young Adult