tailieunhanh - Vaginal Surgery for Incontinence and Prolapse - part 2

Dòng pubococcygeal (mũi tên) được sử dụng như là một điểm tham chiếu radiographically được rút ra từ symphysis mu thua kém các đường giao nhau sacrococcygeal. B: So với các kỳ thi bình thường trong A, hình ảnh này cho thấy sa bàng quang (b) và vòm âm đạo (dài mũi tên | 18 Vaginal Surgery for Incontinence and Prolapse analysis in obese women body mass index BMI 30 kg m2 compared to normal women BMI 25 for incontinence to gas relative risk liquid stool and solid stool although only the risk with liquid stool attained statistical significance. Multivariate analyses were not performed. Many but not all studies of prolapse show a higher risk in overweight and obese women. In cross-sectional data from the Women s Health Initiative the effect of increased weight was consistent and showed the greatest magnitude in obese women with posterior vaginal prolapse adjusted odds ratio compared to normal women. In addition women with apple body shapes waist greater than hip circumference had a 17 higher risk of anterior and posterior vaginal prolapse supporting the theory that increased intraabdominal pressure may play a role in prolapse occurrence. Mant et al 11 reported a stronger effect of weight alone adjusted relative risk compared to BMI weight and height . Longitudinal data from the Women s Health Initiative showed a strong association between increasing BMI and the development of posterior vaginal prolapse but not uterine or anterior vaginal prolapse. Smoking Smoking has been identified as an independent risk factor for urinary incontinence in several studies with the strongest effect seen for stress and mixed incontinence in heavy smokers. The pathophysiologic mechanism may include direct effects on the urethra and indirect effects where smokers generate greater increases in bladder pressure with coughing thus overwhelming the urethra s ability to maintain a watertight seal. No information is available on the effect of smoking on fecal incontinence. Data on smoking and prolapse are contradictory. One study showed no effect of smoking in menopausal women with and without prolapse. In a case-control study of women undergoing surgery for prolapse or incontinence smoking was associated with a doubled risk. However in .

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