Literature DB >> 10711538

Lumbosacral spine and pelvic inlet changes associated with pelvic organ prolapse.

J K Nguyen1, L R Lind, J Y Choe, F McKindsey, R Sinow, N N Bhatia.   

Abstract

OBJECTIVE: To determine the association between advanced pelvic organ prolapse and changes in lumbar lordosis and/or pelvic inlet orientation.
METHODS: Lateral lumbosacral spine/pelvic x-rays were taken of women with grade 2 or greater uterovaginal prolapse and women with grade 1 or less prolapse standing in their usual upright posture. The angles of lumbar lordosis and the pelvic inlet were measured by a radiologist who was masked to the pelvic examination findings.
RESULTS: Twenty women with prolapse were matched with 20 women without significant prolapse. There were no significant differences in the mean (+/- standard deviation [SDI) age (55.3 +/- 9.0 years compared with 53.4 +/- 9.5 years), body mass index (BMI) (28.9 +/- 5.6 compared with 28.4 +/- 5.2), gravidity (5.6 +/- 3.5 compared with 5.0 +/- 2.7), and vaginal parity (4.65 +/- 3.3 compared with 4.5 +/- 2.9) between the prolapse and nonprolapse groups, respectively. All participants were vaginally parous. The mean lumbar lordotic angle in women with pelvic organ prolapse (32.0 degrees +/- 9.8 degrees) was significantly lower than that of controls (42.4 degrees +/- 10.9 degrees) (P < .003). The mean angle of the pelvic inlet in women with pelvic organ prolapse (37.5 degrees +/- 7.0 degrees) was significantly larger than that of controls (29.5 degrees +/- 7.3 degrees) (P < .001). The differences in the mean angles of lumbar lordosis and the pelvic inlet, between the case and control groups, remained significant after multivariable logistic regression was performed.
CONCLUSION: Women with advanced uterovaginal prolapse have less lumbar lordosis and a pelvic inlet that is oriented less vertically than women without prolapse.

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Mesh:

Year:  2000        PMID: 10711538     DOI: 10.1016/s0029-7844(99)00561-x

Source DB:  PubMed          Journal:  Obstet Gynecol        ISSN: 0029-7844            Impact factor:   7.661


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