질식분만이 회음부 하강과 음부신경 말단운동근 잠복기에 미치는 영향
Effect of Vaginal Delivery on Perineal Descent and Pudendal Nerve Terminal Motor Latency
허민희, 최윤미, 우상욱, 김세중, 홍기천, 김종화, 우제홍,
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허민희 ( Hur Min-Hee )
인하대학교 의과대학 일반외과학교실
최윤미 ( Choe Yun-Mee )
인하대학교 의과대학 외과학교실
우상욱 ( Woo Sang-Wook )
인하대학교 의과대학 일반외과학교실
김세중 ( Kim Sei-Joong )
인하대학교 의과대학 외과학교실
홍기천 ( Hong Kee-Chun )
인하대학교 의과대학 일반외과학교실
김종화 ( Kim Jong-Hwa )
인하대학교 의과대학 산부인과학교실
우제홍 ( Woo Ze-Hong )
인하대학교 의과대학 일반외과학교실
KMID : 0356720000160020067
Abstract
Significant associations between perineal descent (PD) and pudendal nerve terminal motor latency (PNTML) have previously been described in patients with fecal incontinence. This had led to the hypothesis that pelvic floor muscle and nerve injury initiated by childbirth might progress and cause fecal incontinence.
Purpose: This study was undertaken to evaluate the association between vaginal delivery and PD, PNTML. Also, we evaluated the correlation between PD and PNTML.
Methods: Sixty one women who visited the Dept. of Surgery from Aug. 1998 to May. 1999 were randomly selected. Women were excluded, who had chronic constipation,operation within 6 months before the investigation, anal trauma, diabetes mellitus, and neurologic disease. They had a mean year of 43 12.5 years (range: 23∼70), a mean vaginal delivery 1.9 1.5 (range: 0∼6). PD at rest and during push, and PNTML were measured.
Results: PD during push (p=0.006) and the change of PD between at rest and during push (p=0.003) were significantly increased with increasing number of vaginal deliveries. Rt PNTML (p=0.08) and Lt PNTML (p=0.03) were significantly increased with increasing number of vaginal deliveries. There was correlation between Lt PNTML and change of PD (r=0.59, p=0.0).
Conclusion: PD and Lt PNTML was increased with repeated vaginal deliveries. Our findings support the hypothesis that damage induced by vaginal delivery to pudendal nerve and pelvic floor will progress.
키워드
Vaginal delivery;Perineal descent;Pudendal nerve terminal motor latency
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