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Study of morphological changes in levator ani muscle of patients with stress urinary incontinence or pelvic organ prolapse
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF OBSTETRICS AND GYNECOLOGY
- Issue:
- 8
- DOI:
- 10.3760/j.issn:0529-567X.2004.08.005
- Key Word:
- 尿失禁,压力性;肛门;肌纤维
Abstract： 目的探讨肛提肌组织形态学的变化及其与压力性尿失禁(stress urinary incontinence,SUI)和盆底组织膨出(pelvic organ prolapse,POP)发病的关系.方法选择15例SUI患者(SUI组)、19例POP患者(POP组)及3例无SUI和POP的直肠癌患者(对照组),术中行肛提肌活检,冰冻切片常规行HE染色、改良Gomori染色及非特异性酯酶(non-specific esterase,NSE)、酸性磷酸酶(acid phosphrase,ACP)、三磷酸腺苷酶(ATPase)染色,镜下观察肛提肌形态学变化.结果成功获取肛提肌肌肉组织与未取得肛提肌肌肉组织的SUI患者的年龄、产次、绝经时间、疾病严重程度、漏尿点压力等比较,差异均无显著性(P＞0.05).SUI组和POP组患者肛提肌组织形态学表现为肌纤维密度降低,排列紊乱,被大量的结缔组织填充、取代,肌纤维周围炎性细胞浸润;单个肌纤维细胞既有核中心移位、纤维劈裂、外周吞噬及空泡变性等肌源性改变,也有肌纤维萎缩、角形变、同型纤维聚集等神经源性改变.结论SUI和POP患者的肛提肌同时存在神经源性和肌源性改变,提示持续的盆底肌去神经支配和继发的肌源性改变,可能是SUR及POP的发病原因之一.
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