Löwik, M. (Marcel) (2015) Influence of position on pelvic floor anatomy, with and without pelvic muscle contraction : A study with 3D perineal ultrasound in women with urge-incontinence. thesis, Medicine.
![[img]](https://umcg.studenttheses.ub.rug.nl/style/images/fileicons/text.png) |
Text
LowikM.pdf Restricted to Registered users only Download (1MB) |
Abstract
Objective The objective of this study is to understand more of the anatomical changes that happen to the pelvic anatomy with position change (supine, sitting and standing), with and without pelvic floor contraction. Our main measurements are hiatal area, width and length. Secondary outcome measurements are levator urethral gap and urethral blood flow (resistance- and pulsatile index). Methods Measurements were taken with perineal 3D-ultrasound in 11 volunteers with urge-incontinence, with no prolaps or pelvic surgery. Volunteers started in rest in supine position followed by pelvic floor contraction, blood flow was measured last. After supine volunteers sat up and measurements where repeated and again in standing position, without blood flow measurements. Results Hiatal area reduced significantly in supine and standing position with pelvic floor contraction in supine position from 14.63 to 12.29 cm2 and in standing position from 16.27 to 14.49 cm2. The hiatal area during contraction did not significantly change in the sitting position; it went from average 14.44 to 13.66 cm2. The mean length of the hiatus in supine position decreased with contraction from 5.32 to 4.71 cm, in sitting position from 5.37 to 4.99 cm and in standing position from 5.66 to 5.06 cm. Pelvic floor contraction gave a significant length reduction in supine and standing position, however no significance in sitting position. The width decreased wile contracting from 4.01 to 3.66 cm in supine position, 3.86 to 3.75 cm in sitting position and increased from 3.97 to 3.99 cm in standing position, where only supine position was significant. The hiatal area decreased from supine to sitting position and increased in standing position, with no significant difference. With pelvic floor contraction the hiatal area increased from supine, to sitting and standing, with no significant differences between the groups. The length in rest and with contraction increases from supine to sitting to standing. The width in rest and with pelvic floor contraction has no significance difference in different positions. The difference in width with and without contraction is significant between supine and standing. Blood flow shows a decrease in pulsatile index from supine to sitting (7,1 to 5,1) and decrease of resistance index from 1,1 to 1,0. Conclusion From the data we collected we can conclude that in women with urge incontinence there are no significant changes in hiatal area, length or width with change in position, either in rest or with pelvic floor muscle exercise. Data however shows a trend that hiatal area increases from the supine to the standing position, both at rest and with pelvic muscle contraction, likely due to the effect of gravity on the pelvic organs. The smaller change in hiatal area with pelvic floor contraction in the standing and sitting position suggests that pelvic muscle contractions are less able to counter the effect of gravity in the standing and sitting position than in the supine position.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and Malmberg, G.G.A. |
| Supervisor name: | Local supervisor: and Arya, dr. L. and Location: Pelvic center in the hospital of the University of |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:05 |
| Last Modified: | 25 Jun 2020 11:05 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2533 |
Actions (login required)
 |
View Item |