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| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 李偉嘉 | 以超音波評估男性骨盆底肌肉功能 | 2011/5/29 下午 04:20:36 | 0 |
| 原 文 | 題 目 | Assessing muscle function of the male pelvic floor using real time ultrasound. |
| 作 者 | Nahon I, Waddington G, Adams R and Dorey G. | |
| 出 處 | Neurourology and Urodynamics | |
| 出版日期 | Neurourol Urodyn. 2011 May 11. doi: 10.1002/nau.21069. [Epub ahead of print] | |
| 評 論 | 相對於女性而言，男性的骨盆底肌肉功能較不被學界所重視，這是因為男人的尿道較長，而且有一個前列腺能維持較高的尿道壓，所以不容易因骨盆底肌肉功能不良而產生尿失禁。然而當男人罹患前列腺癌，而接受前列腺根除術後，骨盆底肌肉的功能是否完善就關係著尿失禁產生與否。Nahon I 等人發表使用3.5MHz探頭，以數位超音波檢查測量28位接受前列腺癌治療的男性，了解其骨盆底肌肉運動的情形。傳統上，醫師是由肛門指檢進行評估。此項超音波檢查顯示禁尿功能正常的患者，其膀胱壁肌肉的移動較多。而尿失禁的患者因為結疤等因素使得骨盆底肌肉的移動較為困難。這項超音波檢查有幾項用途，1. 與肛門指檢同時進行，以了解男性骨盆底肌肉功能。2. 可用於生物回饋機制，訓練骨盆底肌肉收縮。3. 對於如直腸癌術後等，肛門指檢困難的病人，超音波可代行檢查。 | |
| abstract |
Aims: Following surgical removal of the prostate, there may be compromise to the function of the pelvic floor muscles causing continence problems. Assessing the pelvic floor muscles of male patients can be an invasive process that causes discomfort, making it worthwhile to evaluate alternatives to the conventional method of Digital Rectal Examination (DRE). Real time ultrasound (RTUS) has been used with female patients as an alternative to internal assessments. This paper examines the reliability and validity of assessing the male pelvic floor using abdominal RTUS. Methods: Twenty-eight men (meanage66.2)with a history of treatment for prostate cancer were recruited to the study. They were assessed via DRE and RTUS. Findings from the procedures were correlated for evaluation of validity, and the RTUS readings were repeated by different therapists to assess reliability. Results: Measurements on screen correlated moderately with DRE findings (r =0.57, P= 0.002), and RTUS was found to have good reliability (Intra-class Correlation Coefficient 0.90). Continent men had more movement of the bladder wall on RTUS than those who were incontinent (P 0.043). Scar tissue and an inability to maintain a moderately full bladder were found to cause the most difficulty in getting a complete picture of pelvic floor movement. Conclusions: RTUS can be used clinically to examine male pelvic floor function, and its use would be enhanced once it has been established by DRE that a true pelvic floor contraction is occurring. RTUS can give an indication of pelvic floor function as an alternative measurement method when DRE is contraindicated. |
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