Name: anogenital distance and perineal measurements of the pelvic organ prolapse (pop) quantification system
Uploaded: 2018-09-20T12:30:00
Description: Watch this Scientific Journal Video about Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse POP Quantification System at JoVE.com

这项工作得到了经济和竞争力部的支持, ISCIII (AES), 赠款没有 PI13/01237 和该基金会, 穆尔西亚区域科技局, 不给予 19443/PI/14。为这一条款支付公开存取出版费的资金由经济和竞争力部提供, ISCIII (AES), 不给予 PI13/01237。

这项研究是由穆尔西亚大学伦理研究委员会批准的。从所有参与者获得书面知情同意。
1. 会阴测量
注: 在进行测量之前, 必须对两名观察者进行培训, 以尽量减少观察者之间的变异性。
<ol><li>
病人准备
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<li>将病人置于一个碎石的位置, 以45°角的大腿为检查桌。</li>
		<li>使用有分辨率长度为0.000500 英寸的数字卡尺 (图 2A</stro...

<ol>
	<li>Greenham, L. W., Greenham, V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Sexing+mouse+pups.">Sexing mouse pups.</a> Laboratory animals. 11 (3), 181-184 (1977).</li><li>Kurzrock, E. A., Jegatheesan, P., Cunha, G. R., Baskin, L. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Urethral+development+in+the+fetal+rabbit+and+induction+of+hypospadias:+a+model+for+human+development.">Urethral development in the fetal rabbit and induction of hypospadias: a model for human development.</a> The Journal of urology. 164 (5), 1786-1792 (2000).</li><li>Swan, S. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Decrease+in+anogenital+distance+among+male+infants+with+prenatal+phthalate+exposure.">Decrease in anogenital distance among male infants with prenatal phthalate exposure.</a> Environmental health perspectives. 113 (8), 1056-1061 (2005).</li><li>Swan, S. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=First+trimester+phthalate+exposure+and+anogenital+distance+in+newborns.">First trimester phthalate exposure and anogenital distance in newborns.</a> Human Reproduction. 30 (4), 963-972 (2015).</li><li>Bornehag, C. -. G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prenatal+phthalate+exposures+and+anogenital+distance+in+Swedish+boys.">Prenatal phthalate exposures and anogenital distance in Swedish boys.</a> Environmental health perspectives. 123 (1), 101-107 (2015).</li><li>Dean, A., Sharpe, R. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clinical+review:+Anogenital+distance+or+digit+length+ratio+as+measures+of+fetal+androgen+exposure:+relationship+to+male+reproductive+development+and+its+disorders.">Clinical review: Anogenital distance or digit length ratio as measures of fetal androgen exposure: relationship to male reproductive development and its disorders.</a> The Journal of clinical endocrinology and metabolism. 98 (6), 2230-2238 (2013).</li><li>Jain, V. G., Singal, A. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Shorter+anogenital+distance+correlates+with+undescended+testis:+a+detailed+genital+anthropometric+analysis+in+human+newborns.">Shorter anogenital distance correlates with undescended testis: a detailed genital anthropometric analysis in human newborns.</a> Human Reproduction. 28 (9), (2013).</li><li>Arfi, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=First-trimester+determination+of+fetal+gender+by+ultrasound:+measurement+of+the+ano-genital+distance.">First-trimester determination of fetal gender by ultrasound: measurement of the ano-genital distance.</a> European journal of obstetrics, gynecology, and reproductive biology. , 177-181 (2016).</li><li>Sipahi, M., Tokg&#246;z, V. Y., Alanya Tosun, &. #. 3. 5. 0. ;. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+appropriate+way+to+predict+fetal+gender+at+first+trimester:+anogenital+distance.">An appropriate way to predict fetal gender at first trimester: anogenital distance.</a> The journal of maternal-fetal &amp; neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. , 1-5 (2018).</li><li>Mendiola, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Anogenital+distance+is+related+to+ovarian+follicular+number+in+young+Spanish+women:+a+cross-sectional+study.">Anogenital distance is related to ovarian follicular number in young Spanish women: a cross-sectional study.</a> Environmental health: a global access science source. 11 (1), 90 (2012).</li><li>Mira-Escolano, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Longer+anogenital+distance+is+associated+with+higher+testosterone+levels+in+women:+a+cross-sectional+study.">Longer anogenital distance is associated with higher testosterone levels in women: a cross-sectional study.</a> BJOG: An International Journal of Obstetrics &amp; Gynaecology. 121 (11), 1359-1364 (2014).</li><li>Mira-Escolano, M. -. P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Anogenital+distance+of+women+in+relation+to+their+mother's+gynaecological+characteristics+before+or+during+pregnancy.">Anogenital distance of women in relation to their mother's gynaecological characteristics before or during pregnancy.</a> Reproductive BioMedicine Online. 28 (2), 209-215 (2014).</li><li>Barrett, E. S., Parlett, L. E., Swan, S. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Stability+of+proposed+biomarkers+of+prenatal+androgen+exposure+over+the+menstrual+cycle.">Stability of proposed biomarkers of prenatal androgen exposure over the menstrual cycle.</a> Journal of developmental origins of health and disease. 6 (2), 149-157 (2015).</li><li>Wu, Y., Zhong, G., Chen, S., Zheng, C., Liao, D., Xie, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Polycystic+ovary+syndrome+is+associated+with+anogenital+distance,+a+marker+of+prenatal+androgen+exposure.">Polycystic ovary syndrome is associated with anogenital distance, a marker of prenatal androgen exposure.</a> Human reproduction. 32 (4), 937-943 (2017).</li><li>Barrett, E. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Anogenital+distance+in+newborn+daughters+of+women+with+polycystic+ovary+syndrome+indicates+fetal+testosterone+exposure.">Anogenital distance in newborn daughters of women with polycystic ovary syndrome indicates fetal testosterone exposure.</a> Journal of Developmental Origins of Health and Disease. , 1-8 (2018).</li><li>S&#225;nchez-Ferrer, M. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Presence+of+polycystic+ovary+syndrome+is+associated+with+longer+anogenital+distance+in+adult+Mediterranean+women.">Presence of polycystic ovary syndrome is associated with longer anogenital distance in adult Mediterranean women.</a> Human Reproduction. 32 (11), 2315-2323 (2017).</li><li>Mendiola, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Endometriomas+and+deep+infiltrating+endometriosis+in+adulthood+are+strongly+associated+with+anogenital+distance,+a+biomarker+for+prenatal+hormonal+environment.">Endometriomas and deep infiltrating endometriosis in adulthood are strongly associated with anogenital distance, a biomarker for prenatal hormonal environment.</a> Human reproduction. 31 (10), 2377-2383 (2016).</li><li>S&#225;nchez-Ferrer, M. L., Moya-Jim&#233;nez, L. C., Mendiola, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+the+anogenital+distance+and+anthropometry+of+the+perineum+in+patients+with+and+without+pelvic+organ+prolapse.">Comparison of the anogenital distance and anthropometry of the perineum in patients with and without pelvic organ prolapse.</a> Actas urologicas espanolas. 40 (10), 628-634 (2016).</li><li>Gallavan, R. H., Holson, J. F., Stump, D. G., Knapp, J. F., Reynolds, V. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Interpreting+the+toxicologic+significance+of+alterations+in+anogenital+distance:+Potential+for+confounding+effects+of+progeny+body+weights.">Interpreting the toxicologic significance of alterations in anogenital distance: Potential for confounding effects of progeny body weights.</a> Reproductive Toxicology. 13 (5), 383-390 (1999).</li><li>Bump, R. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+standardization+of+terminology+of+female+pelvic+organ+prolapse+and+pelvic+floor+dysfunction.">The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction.</a> American journal of obstetrics and gynecology. 175 (1), 10-17 (1996).</li><li>Haylen, B. T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+International+Urogynecological+Association+(IUGA)+/+International+Continence+Society+(ICS)+Joint+Report+on+the+Terminology+for+Female+Pelvic+Organ+Prolapse+(POP).">An International Urogynecological Association (IUGA) / International Continence Society (ICS) Joint Report on the Terminology for Female Pelvic Organ Prolapse (POP).</a> Neurourology and Urodynamics. 35 (2), 137-168 (2016).</li><li>Lince, S. L., van Kempen, L. C., Vierhout, M. E., Kluivers, K. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+systematic+review+of+clinical+studies+on+hereditary+factors+in+pelvic+organ+prolapse.">A systematic review of clinical studies on hereditary factors in pelvic organ prolapse.</a> International Urogynecology Journal. 23 (10), 1327-1336 (2012).</li><li>&#346;liwa, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Analysis+of+prevalence+of+selected+anamnestic+factors+among+women+with+pelvic+organ+prolapse.">Analysis of prevalence of selected anamnestic factors among women with pelvic organ prolapse.</a> Advances in clinical and experimental medicine: official organ Wroclaw Medical University. 27 (2), 179-184 (2018).</li><li>Espu&#241;a Pons, M., Rebollo Alvarez, P., Puig Clota, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=[Validation+of+the+Spanish+version+of+the+International+Consultation+on+Incontinence+Questionnaire-Short+Form.+A+questionnaire+for+assessing+the+urinary+incontinence].">[Validation of the Spanish version of the International Consultation on Incontinence Questionnaire-Short Form. A questionnaire for assessing the urinary incontinence].</a> Medicina clinica. 122 (8), 288-292 (2004).</li><li>Sandvik, H., Seim, A., Vanvik, A., Hunskaar, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+severity+index+for+epidemiological+surveys+of+female+urinary+incontinence:+comparison+with+48-hour+pad-weighing+tests.">A severity index for epidemiological surveys of female urinary incontinence: comparison with 48-hour pad-weighing tests.</a> Neurourology and urodynamics. 19 (2), 137-145 (2000).</li><li>Hall, A. F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Interobserver+and+intraobserver+reliability+of+the+proposed+International+Continence+Society,+Society+of+Gynecologic+Surgeons,+and+American+Urogynecologic+Society+pelvic+organ+prolapse+classification+system.">Interobserver and intraobserver reliability of the proposed International Continence Society, Society of Gynecologic Surgeons, and American Urogynecologic Society pelvic organ prolapse classification system.</a> American journal of obstetrics and gynecology. 175 (6), (1996).</li><li>Persu, C., Chapple, C. R., Cauni, V., Gutue, S., Geavlete, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pelvic+Organ+Prolapse+Quantification+System+(POP-Q)+-+a+new+era+in+pelvic+prolapse+staging.">Pelvic Organ Prolapse Quantification System (POP-Q) - a new era in pelvic prolapse staging.</a> Journal of medicine and life. 4 (1), 75-81 (2011).</li><li>Lowder, J. L., Oliphant, S. S., Shepherd, J. P., Ghetti, C., Sutkin, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Genital+hiatus+size+is+associated+with+and+predictive+of+apical+vaginal+support+loss.">Genital hiatus size is associated with and predictive of apical vaginal support loss.</a> American journal of obstetrics and gynecology. 214 (6), (2016).</li><li>Vakili, B., Zheng, Y. T., Loesch, H., Echols, K. T., Franco, N., Chesson, R. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Levator+contraction+strength+and+genital+hiatus+as+risk+factors+for+recurrent+pelvic+organ+prolapse.">Levator contraction strength and genital hiatus as risk factors for recurrent pelvic organ prolapse.</a> American Journal of Obstetrics and Gynecology. 192 (5), 1592-1598 (2005).</li><li>Cheung, R. Y. K., Lee, L. L. L., Chung, T. K. H., Chan, S. S. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Predictors+for+dislodgment+of+vaginal+pessary+within+one+year+in+women+with+pelvic+organ+prolapse.">Predictors for dislodgment of vaginal pessary within one year in women with pelvic organ prolapse.</a> Maturitas. 108, 53-57 (2018).</li><li>Khunda, A., Shek, K. L., Dietz, H. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Can+ballooning+of+the+levator+hiatus+be+determined+clinically?.">Can ballooning of the levator hiatus be determined clinically?.</a> American journal of obstetrics and gynecology. 206 (3), (2012).</li><li>Dietz, H. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultrasound+imaging+of+the+pelvic+floor.+Part+II:+three-dimensional+or+volume+imaging.">Ultrasound imaging of the pelvic floor. Part II: three-dimensional or volume imaging.</a> Ultrasound in obstetrics &amp; gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 23 (6), 615-625 (2004).</li></ol>

本文介绍了根据 AGD 概念和弹出 Q 系统进行会阴测量的程序。两个规程用不同的测量系统描述: AGD 测量以卡尺在毫米, 并且弹出 Q 测量以标尺在厘米。应该统一测量仪器和方法的准确性, 而不仅仅是地标。这是非常重要的, 因为一个措施越可重现, 就越可靠。这也将保证不同工作组之间的措施比较, 并尽量减少不同观察员之间的偏见风险。目前, 在弹出 Q 脱垂分级系统中, 只有 PB 和 GH 的措施是标准化?...

生殖器距离 (AGD) 是一种容易接触和无创的人体测量(图 1).AGD 是胎盘哺乳动物的性异形, 在雄性中比雌性长两倍。它被认为是子宫内激素环境的标志物1,2。AGD 与产前接触内分泌干扰物质3,4,5和雄激素在生殖发育的关键时期6,7。在产前会诊中, AGD 可能是有用的确定胎儿性别的准确率在第一个月 (扫描 11-13, 6 周妊娠)8,9。在成年妇女中, AGD 长度与女性生殖功能10、11、12、13有关。在成年女性中, AGD 距离越长, 对卵巢卵泡10和睾酮水平提高11的横断面研究就越多。较长的 AGD 的年轻妇女有几次更可能有不规则月经周期的母亲, 这表明母亲的潜在 hyperandrogenic 宫内环境足以改变雌性后代的生殖道12。最近, 吴等。14已经表明多囊卵巢综合征 (PCOS) 的存在与中国妇女的 AGD 测量和巴雷特等有关。15还报告了多囊卵巢综合征妇女的新生女儿较长的 AGD15。我们的研究小组也证实了这一发现在成人地中海妇女16。另一方面, AGD 与子宫内膜异位症17的存在和严重程度呈负相关, 表明 AGD 作为发育抗雄激素/雌激素暴露的生物标志物的潜能。关于女性会阴和生殖器的定义和测量仍然存在争议。以前的人类研究在提到 AGD 时应用了多种测量方法。在女性中, 在 AGD 措施的解剖学参考中观察到一些修改。当 AGD 第一个被描述和测量在妇女, 解剖地标的较低的参考是 "中间" 肛门。目前, 较低的参考是建立作为肛门的上边缘, 因为它是一个更准确的参考, 使 AGD 一个更可重复的措施18。AGD 测量必须通过重量或 BMI 来纠正, 因为它们是人体尺寸19的测量指标。
类似的测量组是骨盆器官脱垂定量系统 (POP Q)20 , 包括两个会阴测量: 会阴体 (PB) 长度和生殖器中断 (GH) 长度(图 1)。这些测量标准是根据国际节制学会标准化的, 通常用于临床实践和生物医学研究, 特别是在盆腔器官脱垂 (POP)21的妇女中。PB 是从生殖器间隙后缘到 midanal 开口的测量, 相当于 AGDAF (fourchette)。GH 与 anoclitoral 不完全相关,尽管它是模拟测量。有流行音乐的女性有一个强大的家族协会22, 和奇偶校验也被认为是一个风险因素的流行23。然而, 没有任何数据可以推测它们遭受了异常的荷尔蒙环境, 可能与其他生殖问题有关。然而, 由于测量的相似性, 我们推测短铅的女性也会有较短的 AGDAF 。
在本文中, 我们提出两个程序, 并评估其相似性, 以确保这些测量的一致性, 在研究和临床实践。根据我们的知识, 没有显示如何执行这些测量的视频出版物。本研究的主要目的是说明如何执行 AGD 测量 : ( AGDAC) 和 fourchette ( AGD AF) , 以及如何测量 GH 和 PB 长度。第二个目标是比较这两套人体测量措施的妇女与流行 (病例) 和无症状妇女没有盆底障碍 (控制妇女)。
2014年8月至 2015年6月, 在穆尔西亚地区 (西班牙东南部) 的大学临床医院 "Virgen de Arrixaca" 的妇产科进行了病例对照研究。案件是40岁以上的妇女寻求治疗生殖器肿块。如果在妇科检查中证实了 pop, 并将其归类为第二阶段或更多的流行 Q 分类20, 妇女被邀请参加, 无论受影响的车厢 (前, 中或后)。需要手术治疗的压力性尿失禁的妇女被排除在外。对照年龄相仿的妇女寻求例行妇科检查, 既没有骨盆底疾病, 也没有其他妇科疾病, 如附属装置或子宫肌瘤。这两种病例和对照的排除标准如下: 先前的骨盆底疾病或尿失禁矫正手术;改变盆底的力学和生物统计学的活性肿瘤;外生殖器道的主动感染;和外痔疮。有运动障碍的妇女阻止医生采取测量也被排除。完整的妇科和产科病史, 包括月经和产科配方 (奇偶校验, 阴道和器械分娩和出生体重), 以及医疗和外科病史, BMI。使用 ICIQ 调查表24和 Sandvik 严重性指数25对妇女进行了流行和/或尿失禁症状的询问。
用流行 Q 分类系统评估盆腔状态。用一次性导尿管排空膀胱, 引入300毫升生理盐水, 对压力性尿失禁进行了试验。患者进行佛氏演习, 脱垂, 并在减少脱垂后, 隐匿性压力尿失禁诊断。2经阴道超声检查排除子宫或附件疾病。

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		</tr>
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			<td height="40" style="height:40px;">Voluson E8</td>
			<td>General Electric Healthcare</td>
			<td></td>
			<td></td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;">Sterile Utility Skin Marker and Ruler</td>
			<td>Medline</td>
			<td>DYNJSM06</td>
			<td></td>
		</tr>
	</tbody>
</table>

anogenital distance and perineal measurements of the pelvic organ prolapse (pop) quantification system

生殖器距离 (AGD) 是一种性二形属性, 男性比女性长两倍, 是宫内激素环境的标志物。由于对其潜在临床影响的证据越来越多, 对 AGD 测量的兴趣正在增加。一套平行的会阴测量, 骨盆器官脱垂定量系统 (POP Q), 包括类似的, 但不完全相同, 地标: 会阴体 (PB) 和生殖器中断 (GH) 长度。然而, 会阴测量的临床重现性以及它们对会阴测量学的描述都需要阐明。根据我们的知识, 没有任何视频格式的出版物显示这些测量方法。这项工作的主要目的是显示如何正确执行会阴测量学, 包括测量 AGD 在其两个变种 [anoclitoral (AGDAC) 和 anofourchette (AGDAF)], 生殖器中断 (GH) 和会阴体 (PB)。此外, 我们还探讨了在这些测量中是否有与盆腔器官脱垂 (POP) 妇女的差异。我们研究了会阴的人体测量特性, 如 AGD (确定产前) 是否可以改变这些妇女, 并成为骨盆底功能障碍的独立病因。我们展示了两种不同的方法来测量会阴长度, 因为它们可能相当相似。我们的建议是, 统一会阴测量可用于临床和生物医学调查。需要更多的研究, 以比较 GH 和 PB 测量及其 AGD 对应, 以分析哪些程序是更具重现性, 较少内和 interobserver 的变异性。

包括五十八例患者。以前的妇女研究报告说, 最低 AGD 距离是24毫米12 , 标准偏差约10毫米12。在 AGD ac 中, 根据至少12毫米的差异, 检测各组与 AGD交流(I 型误差α = 0.05 和 ii 型误差β = 0.1) 之间的显著差异的最小样本大小估计为25个个体 (50%)./c3> 两组之间。还增加了八名参与者, 以减轻潜在损失。对于80% 的学习能力, 每组个体的数?...

Watch this Scientific Journal Video about Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse POP Quantification System at JoVE.com

Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse POP Quantification System

本手稿描述的程序执行生殖器距离 (AGD) 和会阴测量标准化的骨盆器官脱垂定量系统 (POP Q): 会阴体 (PB) 和生殖器中断 (GH)。这些测量是比较的妇女与没有盆腔器官脱垂。

盆腔器官脱垂 (POP) 定量系统的生殖器距离和会阴测量

Anogenital distance (AGD) is a sexually dimorphic attribute, twice longer in males than in females, and a marker of intrauterine hormonal environment. ...

这种方法可以帮助回答流行病学和子宫内科学领域有关内皮测量的临床可重复性及其在描述内膜人类测量的有用性方面的关键问题。此技术的主要优点是测量很容易从视觉演示中学习。首先帮助患者进入大腿以45度角到检查台的脂管学位置。选择分辨率长度为 0.0005 英寸的数字卡钳并关闭设备，确认显示屏上出现零。选择毫米作为测量单位。测量从前表面到阿努斯上边缘的距离。接下来，测量从子宫后缘到角角上边缘的无福萨距离。为了提高观察者之间的精度，让第二个检查员执行每次测量三次，每个检查员每次非侵入性测量总共获得六次测量。然后，使用两组测量值的平均值作为每个肛门距离和后续分析的真实估计值。消毒卡钳。对于骨盆器官脱垂定量，使用带有厘米标记的测量工具测量生殖器从外部尿道肉的中间到子宫后边缘到最近的半厘米三次的生殖器间歇。然后，测量从子宫后缘到中肛门开口三次的周内体。在后续分析中使用两组测量值的平均值。在这项具有代表性的研究中，观察到患者与对照研究参与者在年龄、分娩数量和出生体重方面存在显著差异。值得注意的是，与对照参与者相比，骨盆器官脱垂患者的和无阴分距离存在显著差异。骨盆器官脱垂患者的生殖器间歇长度也比对照参与者长，两组患者的周围体距离没有显著差异。我们发现 AGD ，无福长，这是较短的脱垂和 AGD 的情况下，和生殖器间歇长度，这是更长的妇女脱垂。我们的数据表明，围尿的测量特征，如较短的AGD ano-fossa长度，可以确定产前，可能是一个独立的病因因素，预测怀孕的流动功能障碍。需要进一步调查，以评估AGD和POCU测量的可比性。将测量仪器和方法的准确性普遍化，以保证不同工作组之间的测量可比性，并尽量减少观察员之间的视觉偏差，可能是有益的。

Research

JoVE Journal

Medicine

Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse (POP) Quantification System

Intraoperative Detection of Subtle Endometriosis: A Novel Paradigm for Detection and Treatment of Pelvic Pain Associated with the Loss of Peritoneal Integrity

术中的微妙的子宫内膜异位症的检测：A新型范式为相关联的与的的腹膜的完整性之亏损盆腔疼痛的的的的检测和治疗的

Endometriosis is a  common disease affecting 40 to 70% of reproductive-aged women with chronic  pelvic pain (CPP) and/or infertility. The purpose of this ...

科研

医学

Technique of Subnormothermic Ex Vivo Liver Perfusion for the Storage, Assessment, and Repair of Marginal Liver Grafts

Technique of Subnormothermic Ex Vivo Liver Perfusion for the Storage, Assessment, and Repair of Marginal Liver Grafts

Subnormothermic的技术<em&gt;前体内</em&gt;肝脏灌注的存储，评估和修复边际移植肝

The success of liver transplantation has resulted in a dramatic organ shortage. In most transplant regions 20-30% of patients on the waiting list for ...

Technique of Porcine Liver Procurement and Orthotopic Transplantation using an Active Porto-Caval Shunt

使用Active波尔图腔静脉分流术猪肝脏采购和原位移植技术

The success of liver transplantation has resulted in a dramatic organ shortage. Each year, a considerable number of patients on the liver transplantation ...

Cardiac Catheterization in Mice to Measure the Pressure Volume Relationship: Investigating the Bowditch Effect

心导​​管在小鼠测量压力体积的关系：调查的影响鲍迪奇

Animal models that mimic human cardiac disorders have been created to test potential therapeutic strategies. A key component to evaluating these ...

Generation of Organ-conditioned Media and Applications for Studying Organ-specific Influences on Breast Cancer Metastatic Behavior

器官空调，媒体和应用的产生对乳腺癌转移行为研究器官特异性的影响

Breast cancer preferentially metastasizes to the lymph node, bone, lung, brain and liver in breast cancer patients. Previous research efforts have focused ...

Transvaginal Mesh Insertion in the Ovine Model

经阴道网格插入在牛模型中

This protocol describes mesh insertion into the rectovaginal septum in sheep using a single vaginal incision technique, with and without the trocar-guided ...

Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse

男性和女性盆腔器官脱垂的磁共振成像对左旋的定量研究

Here we present a protocol to examine the levator ani hiatus in males and females with pelvic organ prolapse, during the Valsalva maneuver and while ...

The Rigid Tube as an Alternative in Controlling the Problematic Airway

刚性管作为控制问题气道的替代方案

The unexpected problematic airway represents a large proportion of anesthesia-related morbidity and mortality. The retromolar or paraglossal approach is ...

Organ Ischemia-Reperfusion Injury by Simulating Hemodynamic Changes in Rat Liver Transplant Model

器官缺血-输液损伤模拟大鼠肝脏移植模型的血动力学变化

Orthotopic liver transplantation (OLT) in rats is a tried and proven animal model used for preoperative, intraoperative, and postoperative studies, ...