目标:尽管患病率很高,关于盆底功能障碍的自然史的信息很少。我们的目的是确定患病率,盆腔器官脱垂(POP)的发生率和持久性,6-7年以上的肠和泌尿症状及其相关因素。
方法:来自亚洲中年队列的女性完成了基线和6-7年随访评估。使用经过验证的问卷在基线时获得社会人口统计学特征和健康状况。客观测量体重指数(BMI)和物理性能。
方法:POP,肠,在两个时间点,使用盆底窘迫量表简表20测量排尿功能障碍。采用二元logistic回归分析基线危险因素与患病率之间的独立关联,新,和持续的症状。
结果:在基线时登记的1201名女性中,62.3%有至少一个领域的盆底功能障碍症状。睡眠不好,较差的健康感知,残疾与普遍的盆底症状有关,睡眠不足使POP事件的调整风险增加了一倍(调整后的优势比,OR:2.3,95%置信区间:1.4-3.9),在6.6年的随访中,肠(aOR:2.3,1.4-3.7)和尿(aOR:1.7,1.1-2.9)症状。绝经后妇女流行POP(aOR:0.5,0.3-0.7)和泌尿症状(aOR:0.4,0.3-0.6)的风险降低,以及降低发生尿路症状的风险(aOR:0.4,0.2-0.8)。基线时良好的身体表现评分降低了肠道症状的风险(aOR:0.5,0.2-0.9),而肥胖增加了持续症状的风险。
结论:睡眠质量差独立预测盆底功能障碍性事件,而不良的身体表现与肠道症状相关。
OBJECTIVE: Despite its high prevalence, little information is available on the natural history of pelvic floor dysfunction. We aimed to determine the prevalence, incidence and persistence of pelvic organ prolapse (POP), bowel and urinary symptoms over 6-7 years and its associated factors.
METHODS: Women from a midlife cohort in Asia completed baseline and 6-7-year follow-up assessments. Sociodemographic characteristics and health conditions were obtained at baseline using validated questionnaires. Body mass index (BMI) and physical performance were objectively measured.
METHODS: POP, bowel, and urinary dysfunction were measured using the Pelvic Floor Distress Inventory Short Form 20 at both timepoints. Binary logistic regression was used to analyze independent associations between baseline risk factors and prevalent, new, and persistent symptoms.
RESULTS: Of the 1201 women enrolled at baseline, 62.3 % had symptoms in at least one domain of pelvic floor dysfunction. Poor sleep, poorer perceived health, and disability were associated with prevalent pelvic floor symptoms, while poor sleep doubled the adjusted risk of incident POP (adjusted odds ratio, aOR: 2.3, 95 % Confidence Interval: 1.4-3.9), bowel (aOR: 2.3, 1.4-3.7) and urinary (aOR: 1.7, 1.1-2.9) symptoms at the 6.6-year follow-up visit. Postmenopausal women had reduced risks of prevalent POP (aOR: 0.5, 0.3-0.7) and urinary symptoms (aOR: 0.4, 0.3-0.6), as well as a reduced risk of developing incident urinary symptoms (aOR: 0.4, 0.2-0.8). Good physical performance scores at baseline reduced the risk of incident bowel symptoms (aOR: 0.5, 0.2-0.9), whereas obesity increased the risks of persistent symptoms.
CONCLUSIONS: Poor sleep quality independently predicted incident pelvic floor dysfunction, while poor physical performance was associated with incident bowel symptoms.