骨盤内臓器の位置評価における体位の影響の検討

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  • The influence of posture on evaluation of pelvic organ position
  • コツバンナイ ゾウキ ノ イチ ヒョウカ ニ オケル タイイ ノ エイキョウ ノ ケントウ

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Abstract

type:Departmental Bulletin Paper

The influence of the gravity should be considered for the evaluation of pelvic organ positions. This studyinvestigated the influence of posture on pelvic organ positions. Bladder neck position and mobility, and internal uterine osposition in the supine, sitting, and standing postures were compared in 9 parous women (28–48 years). Sagittal T1-weightedimages and T2-weighted images of the pelvis were acquired for evaluating the bladder neck position at rest and at pelvicstrain, and the internal uterine os position at rest, respectively, using a GE SIGNA SP/2 open-configuration magneticresonance system. The distance from the pubococcygeal line to the bladder neck and the internal uterine os were measured,and both of positions were shown as being higher (+) or lower (-) than the pubococcygeal line. Median bladder neckposition in the supine posture at rest was +15.6 mm (range, +9.3 – +23.4). The bladder neck position was significantly lowerin the sitting than in the supine (difference, 6.9 mm; 95% CI, 3.6 to 13.6 mm; p < 0.016) or standing (difference, 15.2 mm;95% CI, 10.0 to 22.9 mm; p < 0.016) postures. Similarly, the internal uterine os positions were also low in the order ofsupine, sitting, and standing postures. The position of bladder neck and internal uterine os showed positive correlation (r =0.63 to 0.88, p < 0.01). Bladder neck mobility did not differ among postures. But, the bladder neck position at pelvic strainwas also low in the order of supine, sitting, and standing postures. Thus, we suggest that the posture should be consideredfor the evaluation of pelvic organs.

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