Author/Editor		Barbič, Matija
Title		Pomen mišičja medeničnega dna in tkivne sestave endopelvične fascije na mobilnost vratu mehurja
Translated title		Role of the pelvic floor muscles and tissue composition of endopelvic fascia to mobility of the bladder neck
Type		monografija
Place		Ljubljana
Publisher		Medicinska fakulteta
Publication year		2003
Volume		str. 61
Language		slo
Abstract		BACKGROUND Supportive structures of the proximal urethra and of the bladder neck play an important role in the mechanism of urinary continence. At sudden increases in intraabdominal pressure they enable the forces of this pressure to compress the soft urethra against its basis. Inefficiency of the supportive structures is clinically manifested as hypermobility of the bladder neck and signs of stress urinary incontinence. The most important components of the supportive structures of proximal urethra and bladder neck are the levator ani muscle and endopelvic fascia. The mechanism involved in ensuring the stability of the supportive structures has not been fully clarified yet. We aimed at finding the role of the activity of the levator ani muscle and the tissue structure of endopelvic fascia in the mobility of the bladder neck. PATIENTS AND METHODS In the study we enrolled 60 women, divided into two matched groups. In the study group (n = 32) we enrolled the women with urodynamically proven stress urinary incontinence in whom Burch colposuspension was to be performed for clinically established hypermobility of the bladder neck. The control group (n = 28) consisted of women with myomatous uterus in whom laparotomy was to be performed. The inclusion criteria were 1-3 vaginal deliveries, regular menstrual cycle and no previous abdominal or vaginal surgeries. In the control group women the additional inclusion criterion was negative pad test. Prior to surgery in all the women who had signed an informed consent for participation in the study, the functional abilities of the proximal urethra was assessed by calculating the urodynamic parameter "pressure transmission ratio" (PTR), whereas the position and mobility of the bladder neck during cough and during contraction of the pelvic floor was assessed using perineal ultrasound. (Abstract truncated at 2000 characters).
Descriptors		URINARY INCONTINENCE, STRESS PELVIC FLOOR BLADDER FASCIA COUGH URODYNAMICS ELECTROMYOGRAPHY IMMUNOHISTOCHEMISTRY COLLAGEN ELASTIC TISSUE URETHRA MANOMETRY