Relationship between levator ani contraction and motor unit activation in the urethral sphincter

被引:17
作者
Kenton, K [1 ]
Brubaker, L [1 ]
机构
[1] Rush Presbyterian St Lukes Med Ctr, Dept Obstet & Gynecol, Div Female Pelv Med & Reconstruct Pelv Surg, Chicago, IL 60612 USA
关键词
levator ani; urethra; electromyography;
D O I
10.1067/mob.2002.123939
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVE: The purpose of this study was to evaluate the relationship between levator ani contraction and motor unit action potential activation in the striated urethral sphincter. STUDY DESIGN: One hundred eight women who underwent preoperative evaluation at our referral center were studied. All women gave a urogynecologic history and underwent physical examination, multichannel urodynamic testing, and urethral sphincter electromyography. Manual muscle testing was used to grade levator ani contractions as poor, moderate, or strong; quantitative electromyography software was used to analyze motor unit action potential activation in the urethral sphincter. RESULTS: Levator ani contractions were graded as poor in 46% of the women, moderate in 31% of the women, and strong in 23% of the women. Manual muscle grade was not related to quantitative electromyography values in the urethral sphincter at rest or with voluntary pelvic floor contraction. Poor manual muscle grade was associated with detrusor instability (P = .004) and more advanced stages of prolapse (P = .037). Levator ani strength was not significantly related to age, genuine stress incontinence, urethrovesical junction hypermobility, menopausal status, or surgical cure rates. CONCLUSION: The ability to contract the levator ani does not appear to be related to the ability to activate motor unit action potentials in the urethral sphincter, which suggests that the function of the levator ani in maintaining urinary continence is independent from the role of the urethral sphincter.
引用
收藏
页码:403 / 406
页数:4
相关论文
共 15 条
[1]   STANDARDIZATION OF TERMINOLOGY OF LOWER URINARY-TRACT FUNCTION [J].
ABRAMS, P ;
BLAIVAS, JG ;
STANTON, SL ;
ANDERSEN, JT .
NEUROUROLOGY AND URODYNAMICS, 1988, 7 (05) :403-427
[2]  
BARBER MD, 2000, P AM UR SOC 22 ANN M
[3]  
BATES B, 1991, GUIDE PHYSICAL EXAMI, P501
[4]   Single blind, randomised controlled trial of pelvic floor exercises, electrical stimulation, vaginal cones, and no treatment in management of genuine stress incontinence in women [J].
Bo, K ;
Talseth, T ;
Holme, I .
BMJ-BRITISH MEDICAL JOURNAL, 1999, 318 (7182) :487-+
[5]   The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction [J].
Bump, RC ;
Mattiasson, A ;
Bo, K ;
Brubaker, LP ;
DeLancey, JOL ;
Klarskov, P ;
Shull, BL ;
Smith, ARB .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1996, 175 (01) :10-17
[6]  
CONSTANTINOU CE, 1985, UROL CLIN N AM, V12, P247
[7]   SPATIAL-DISTRIBUTION AND TIMING OF TRANSMITTED AND REFLEXLY GENERATED URETHRAL PRESSURES IN HEALTHY WOMEN [J].
CONSTANTINOU, CE ;
GOVAN, DE .
JOURNAL OF UROLOGY, 1982, 127 (05) :964-969
[8]   STRUCTURAL SUPPORT OF THE URETHRA AS IT RELATES TO STRESS URINARY-INCONTINENCE - THE HAMMOCK HYPOTHESIS [J].
DELANCEY, JOL .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1994, 170 (06) :1713-1723
[9]  
DIMITRU D, 1995, ELECTRODIAGNOSTIC ME, P225
[10]   EFFICACY OF BLADDER TRAINING IN OLDER WOMEN WITH URINARY-INCONTINENCE [J].
FANTL, JA ;
WYMAN, JF ;
MCCLISH, DK ;
HARKINS, SW ;
ELSWICK, RK ;
TAYLOR, JR ;
HADLEY, EC .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1991, 265 (05) :609-613