The Study On Measurement Of Pelvic Floor Muscle Function With Age And Prediction In Stress Urinary Incontinence

[Objection]To explore the development trends of pelvic floor muscle function with age in the multiparous women without stress urinary incontinence by intravaginal manometery,we compared the differences of the pelvic floor muscle function among different age groups.At the same time,contrasting the pelvic floor muscle function parameters between the urinary continence group and incontinence group to explore the risk factors of stress urinary incontinence(SUI),then the prediction model was established to investigate the predictive role of pelvic floor muscle function on stress urinary incontinence.[Methods]The first part The study on the measurement of pelvic floor muscle function with age There were 144 multiparous women without leakage of urine selected randomly in Fuzhou General Hospital gynecological outpatient and divided into 6 groups according to age.Evaluating the pelvic floor muscle function by intravaginal manometery,maximum vaginal pressure,average pressure,fatigue(ie,the degree of pressure drop within 6s)and collecting time were compared by Kruskal-Wallis test.The second part The study on the predictive role of pelvic floor muscle function in stress urinary incontinence A total of 258 women in gynecological outpatients at Fuzhou General Hospital were divided into urinary incontinence group(n = 114)and non-incontinence group(n =144).Evaluating the pelvic floor muscle function by intravaginal manometery,maximum vaginal pressure,average pressure,fatigue and collecting time were measured and compared by Mann-Whitney U test.The risk factors of urinary incontinence were analyzed by logistic regression with the standard α = 0.05,the exclusion standard α = 0.10,then establishing prediction model of SUI by Classification And Regression Tree(CART).[Results]The first part The study on the measurement of pelvic floor muscle function with age There was no significant difference(p>0.05)in BMI,numbe r of delivery,maximum newborn weight of demographic data between the 6 groups.The same as in pelvic floor muscle function(p>0.05): maximum vaginal pressure,average pressure,fatigue and collecting time.It`s suggested that there was no distinction in pelvic floor muscle function among different groups.The second part The study on the predictive role of pelvic floor muscle function in stress urinary incontinence There was no statistically significant difference in age,parity and delivery mode between the two groups(P> 0.05),but in BMI and maximum newborn weight(P<0.05).There existed significant difference in maximum vaginal pressure,average pressure,fatigue,collecting time of pelvic floor muscle function between the two groups(P <0.01).The risk factors of SUI were analyzed by logistic regression: BMI,maximum vaginal pressure,fatigue,collecting time(P < 0.01).The maximum vaginal pressure and fatigue would increase the risk of SUI,however,BMI and collecting time could reduce the risk of SUI.Prediction model suggested that it would increase the risk of SUI,which factors were maximum vaginal pressure ≤ 26.15 mm Hg,BMI >22.58Kg/m2 and fatigue ≤-55.5%.There was protective effect for SUI with both maximum vaginal pressure > 26.15 mm Hg and collecting time ≤ 1.02 s.When maximum vaginal pressure is greater than 28.2mm Hg,there was almost no occurrence of stress urinary incontinence.Newborn weight beyond 3275g would increase the risk of stress urinary incontinence in the future.Maximum vaginal pressure for SUI was the most important predictor.[Conclusions]1 There was no significant difference in pelvic floor muscle function among groups with different age.The age had little influence on pelvic floor muscle in multiparous continence women;the effect of age on the pelvic floor muscle was mainly to delay the pelvic floor muscle repair and promote the muscle which had been damaged to be dysfunctional.2 As a convenient,quantitative,reproducible well method of pelvic floor muscle function measurement,intravaginal manometery can be widely used in clinical for pelvic floor rehabilitation in postpartum women.3 There were critical factors to predict the occurrence of SUI on BMI>22.585Kg/m2 and vaginal maximum pressure ≤ 26.15 mm Hg.It would decrease the risk of stress urinary incontinence,however,when vaginal maximum pressure>28.2mm Hg.To select high-risk group of SUI and intervene early according to the prediction model,which make sense of reducing incidence of stress urinary incontinence.