Displacement and recovery of the vesical neck position during pregnancy and after childbirth
Aims (i) To describe the displacement and recovery of the vesical neck position during pregnancy and after childbirth and (ii) to discriminate between compliance of the vesical neck supporting structures with and without pelvic floor contraction. Methods We focussed on the biomechanical properties o...
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| Published in: | Neurourology and urodynamics Vol. 26; no. 3; pp. 372 - 376 |
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| Main Authors: | , , , , |
| Format: | Journal Article |
| Language: | English |
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| Abstract | Aims
(i) To describe the displacement and recovery of the vesical neck position during pregnancy and after childbirth and (ii) to discriminate between compliance of the vesical neck supporting structures with and without pelvic floor contraction.
Methods
We focussed on the biomechanical properties of the vesical neck supporting structures during pregnancy and after childbirth by calculating the compliance and the hysteresis as a result from of abdominal pressure measurements and simultaneous perineal ultrasound.
Results
This study shows that compliance of the supporting structures remains relatively constant during pregnancy and returns to normal values 6 months after childbirth. Hysteresis, however, showed an increase after childbirth, persisting at least until 6 months post partum.
Conclusions
Vaginal delivery may stretch and or load beyond the physiological properties of the pelvic floor tissue and in this way may lead to irreversible changes in tissue properties which play an important role in the urethral support continence mechanism. Neurourol. Urodynam. 26:372–376, 2007. © 2007 Wiley‐Liss, Inc. |
|---|---|
| AbstractList | Aims
(i) To describe the displacement and recovery of the vesical neck position during pregnancy and after childbirth and (ii) to discriminate between compliance of the vesical neck supporting structures with and without pelvic floor contraction.
Methods
We focussed on the biomechanical properties of the vesical neck supporting structures during pregnancy and after childbirth by calculating the compliance and the hysteresis as a result from of abdominal pressure measurements and simultaneous perineal ultrasound.
Results
This study shows that compliance of the supporting structures remains relatively constant during pregnancy and returns to normal values 6 months after childbirth. Hysteresis, however, showed an increase after childbirth, persisting at least until 6 months post partum.
Conclusions
Vaginal delivery may stretch and or load beyond the physiological properties of the pelvic floor tissue and in this way may lead to irreversible changes in tissue properties which play an important role in the urethral support continence mechanism. Neurourol. Urodynam. 26:372–376, 2007. © 2007 Wiley‐Liss, Inc. AIMS(i) To describe the displacement and recovery of the vesical neck position during pregnancy and after childbirth and (ii) to discriminate between compliance of the vesical neck supporting structures with and without pelvic floor contraction.METHODSWe focussed on the biomechanical properties of the vesical neck supporting structures during pregnancy and after childbirth by calculating the compliance and the hysteresis as a result from of abdominal pressure measurements and simultaneous perineal ultrasound.RESULTSThis study shows that compliance of the supporting structures remains relatively constant during pregnancy and returns to normal values 6 months after childbirth. Hysteresis, however, showed an increase after childbirth, persisting at least until 6 months post partum.CONCLUSIONSVaginal delivery may stretch and or load beyond the physiological properties of the pelvic floor tissue and in this way may lead to irreversible changes in tissue properties which play an important role in the urethral support continence mechanism. (i) To describe the displacement and recovery of the vesical neck position during pregnancy and after childbirth and (ii) to discriminate between compliance of the vesical neck supporting structures with and without pelvic floor contraction. We focussed on the biomechanical properties of the vesical neck supporting structures during pregnancy and after childbirth by calculating the compliance and the hysteresis as a result from of abdominal pressure measurements and simultaneous perineal ultrasound. This study shows that compliance of the supporting structures remains relatively constant during pregnancy and returns to normal values 6 months after childbirth. Hysteresis, however, showed an increase after childbirth, persisting at least until 6 months post partum. Vaginal delivery may stretch and or load beyond the physiological properties of the pelvic floor tissue and in this way may lead to irreversible changes in tissue properties which play an important role in the urethral support continence mechanism. |
| Author | Weis Potters, Annemarie E. van der Mark, Thomas W. Tinga, Dick J. Wijma, Jacobus Aarnoudse, Jan G. |
| Author_xml | – sequence: 1 givenname: Jacobus surname: Wijma fullname: Wijma, Jacobus email: jac.wijma@wanadoo.nl organization: Martini Hospital Groningen, Groningen, The Netherlands – sequence: 2 givenname: Annemarie E. surname: Weis Potters fullname: Weis Potters, Annemarie E. organization: Deventer Hospital, Deventer, The Netherlands – sequence: 3 givenname: Thomas W. surname: van der Mark fullname: van der Mark, Thomas W. organization: Department of Pulmonology, University Medical Centre Groningen, Groningen, The Netherlands – sequence: 4 givenname: Dick J. surname: Tinga fullname: Tinga, Dick J. organization: Departments of Obstetrics and Gynaecology, University Medical Centre Groningen, Groningen, The Netherlands – sequence: 5 givenname: Jan G. surname: Aarnoudse fullname: Aarnoudse, Jan G. organization: Departments of Obstetrics and Gynaecology, University Medical Centre Groningen, Groningen, The Netherlands |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/17304524$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1002/nau.10116 10.1046/j.1464-410X.2002.02907.x 10.1097/00003081-199312000-00016 10.1097/00003081-199312000-00015 10.1097/01.ju.0000074553.38914.c7 10.1097/00006250-200004000-00011 10.1097/01.ju.0000147305.00443.df 10.1002/1520-6777(2000)19:6<677::AID-NAU5>3.0.CO;2-J 10.1097/00003081-200406000-00013 10.1046/j.1471-0528.2003.02296.x 10.1016/0002-9378(83)90446-5 10.1016/S0090-4295(02)02500-1 10.1111/j.1471-0528.2001.00123.x 10.1016/S0022-4804(03)00125-2 10.1097/00003081-199312000-00017 10.1016/S0002-9378(94)70346-9 |
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| References_xml | – volume: 108 start-page: 726 year: 2001 end-page: 32 article-title: Anatomical and functional changes in the lower urinary tract during pregnancy publication-title: BJOG – volume: 112 start-page: 162 year: 2003 end-page: 7 article-title: Effect of straining on perineal muscles and their role in perineal support: Identification of the straining‐perineal reflex publication-title: J Surg Res – volume: 2 start-page: 40 year: 1990 end-page: 6 article-title: Mechanical properties of fascia during pregnancy: A possible factor in the development of stress incontinence of urine publication-title: Contemp Rev Obstet Gynaecol – volume: 36 start-page: 926 year: 1993 end-page: 38 article-title: Pelvic floor disorders: The role of fascia and ligaments publication-title: Clin Obstet Gynecol – volume: 173 start-page: 149 year: 2005 end-page: 52 article-title: Cough anal reflex: Strict relationship between intravesical pressure and pelvic floor muscle electromyographic activity during cough. Urodynamic and electrophysiological study publication-title: J Urol – volume: 47 start-page: 394 year: 2004 end-page: 403 article-title: Childbirth and pelvic floor disorders publication-title: Clin Obstet Gynecol – volume: 110 start-page: 658 year: 2003 end-page: 63 article-title: Anatomical and functional changes in the lower urinary tract following spontaneous vaginal delivery publication-title: BJOG – volume: 170 start-page: 1713 year: 1994 end-page: 20 article-title: Structural support of the urethra as it relates to stress urinary incontinence: The hammock hypothesis publication-title: Am J Obstet Gynecol – volume: 36 start-page: 897 year: 1993 end-page: 909 article-title: Anatomy and biomechanics of genital prolapse publication-title: Clin Obstet Gynecol – volume: 54 start-page: 244 year: 1974 end-page: 52 article-title: Pelvic anatomy. I. Pelvic floor muscles publication-title: Ann R Coll Surg Engl – volume: 147 start-page: 662 year: 1983 end-page: 6 article-title: Ripening of the human uterine cervix related to changes in collagen, glycosaminoglycans, and collagenolytic activity publication-title: Am J Obstet Gynecol – volume: 22 start-page: 269 year: 2003 end-page: 76 article-title: Compliance of the bladder neck supporting structures: Importance of activity pattern of levator ani muscle and content of elastic fibers of endopelvic fascia publication-title: Neurourol urodyn – volume: 95 start-page: 535 year: 2000 end-page: 40 article-title: Differential effects of cough, valsalva, and continence status on vesical neck movement publication-title: Obstet Gynecol – volume: 170 start-page: 485 year: 2003 end-page: 9 article-title: Pelvic floor muscle behavior during Valsalva leak point pressure measurement in males and females affected by stress urinary incontinence publication-title: J Urol – volume: 19 start-page: 677 year: 2000 end-page: 81 article-title: Differences between cough and Valsalva leak‐point pressure in stress incontinent women publication-title: Neurourol Urodyn – volume: 61 start-page: 544 year: 2003 end-page: 8 article-title: Videourodynamic analysis of the relationship of Valsalva and cough leak point pressures in women with stress urinary incontinence publication-title: Urology – volume: 90 start-page: 408 year: 2002 end-page: 14 article-title: Determining the displacement of the pelvic floor and pelvic organs during voluntary contractions using magnetic resonance imaging in younger and older women publication-title: BJU Int – volume: 36 start-page: 910 year: 1993 end-page: 25 article-title: The muscles of the pelvic floor publication-title: Clin Obstet Gynecol – volume: 54 start-page: 244 year: 1974 ident: e_1_2_1_14_2 article-title: Pelvic anatomy. I. Pelvic floor muscles publication-title: Ann R Coll Surg Engl contributor: fullname: Lawson JO – ident: e_1_2_1_15_2 doi: 10.1002/nau.10116 – ident: e_1_2_1_19_2 doi: 10.1046/j.1464-410X.2002.02907.x – ident: e_1_2_1_4_2 doi: 10.1097/00003081-199312000-00016 – ident: e_1_2_1_3_2 doi: 10.1097/00003081-199312000-00015 – ident: e_1_2_1_9_2 doi: 10.1097/01.ju.0000074553.38914.c7 – ident: e_1_2_1_16_2 doi: 10.1097/00006250-200004000-00011 – volume: 2 start-page: 40 year: 1990 ident: e_1_2_1_12_2 article-title: Mechanical properties of fascia during pregnancy: A possible factor in the development of stress incontinence of urine publication-title: Contemp Rev Obstet Gynaecol contributor: fullname: Landon CR – ident: e_1_2_1_10_2 doi: 10.1097/01.ju.0000147305.00443.df – ident: e_1_2_1_18_2 doi: 10.1002/1520-6777(2000)19:6<677::AID-NAU5>3.0.CO;2-J – ident: e_1_2_1_2_2 doi: 10.1097/00003081-200406000-00013 – ident: e_1_2_1_6_2 doi: 10.1046/j.1471-0528.2003.02296.x – ident: e_1_2_1_13_2 doi: 10.1016/0002-9378(83)90446-5 – ident: e_1_2_1_17_2 doi: 10.1016/S0090-4295(02)02500-1 – ident: e_1_2_1_5_2 doi: 10.1111/j.1471-0528.2001.00123.x – ident: e_1_2_1_8_2 doi: 10.1016/S0022-4804(03)00125-2 – ident: e_1_2_1_11_2 doi: 10.1097/00003081-199312000-00017 – ident: e_1_2_1_7_2 doi: 10.1016/S0002-9378(94)70346-9 |
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(i) To describe the displacement and recovery of the vesical neck position during pregnancy and after childbirth and (ii) to discriminate between... (i) To describe the displacement and recovery of the vesical neck position during pregnancy and after childbirth and (ii) to discriminate between compliance of... AIMS(i) To describe the displacement and recovery of the vesical neck position during pregnancy and after childbirth and (ii) to discriminate between... |
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| SubjectTerms | Adolescent Adult Biomechanical Phenomena Compliance Delivery, Obstetric Female Humans hysteresis Muscle Contraction - physiology Muscle, Skeletal - physiology Parturition pelvic floor Pelvic Floor - diagnostic imaging Pelvic Floor - physiology Postpartum Period - physiology Pregnancy - physiology Prospective Studies Ultrasonography Urethra - diagnostic imaging Urethra - physiology urethral support Urinary Bladder - diagnostic imaging Urinary Bladder - physiology vaginal delivery Valsalva Maneuver - physiology |
| Title | Displacement and recovery of the vesical neck position during pregnancy and after childbirth |
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