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International Urogynecology Journal

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01-11-2020 | Computed Tomography | Original Article

Pelvic floor morphology in the standing position using upright computed tomography: age and sex differences

Authors: Keiichi Narita, Yoshitake Yamada, Minoru Yamada, Yoichi Yokoyama, Takehiro Nakahara, Masahiro Jinzaki

Published in: International Urogynecology Journal | Issue 11/2020

Abstract

Introduction and hypothesis

This study was aimed at comparing pelvic floor parameters between the standing and supine positions using upright computed tomography (CT) and evaluating the effects of sex and age in normal healthy volunteers.

Methods

In total, 139 volunteers (70 men, mean 46.7 years; 69 women, mean 47.3 years) underwent both upright CT in the standing position and conventional CT in the supine position. The distances from the bladder neck to the pubococcygeal line (PCL) and anorectal junction (ARJ), defined as the posterior aspect of the puborectalis muscle, to PCL were measured. The length, width, and area of the levator hiatus (LH) were measured on oblique axial images.

Results

The bladder neck (men, 22.2 ± 4.9 mm vs 28.3 ± 5.3 mm; women, 9.0 ± 5.1 mm vs 19.0 ± 4.0 mm) and ARJ (men, −18.8 ± 5.5 mm vs −12.1 ± 5.1 mm; women, −20.0 ± 4.7 mm vs −11.2 ± 4.3 mm) were significantly lower in the standing position than in the supine position (all p < 0.0001). The LH area (men, 1,990 ± 380 mm² vs 1,697 ± 329 mm²; women, 2,284 ± 344 mm² vs 1,811 ± 261 mm²) was significantly larger in the standing position (both p < 0.0001). Differences in all parameters between the standing and supine positions were larger in women than in men. ARJ in women showed a significant tendency to descend with age only in the standing position (r = −0.29, p = 0.017).

Conclusions

The bladder neck and ARJ descend and the LH area enlarges in the standing position. Pelvic floor mobility is greater in women than in men. Descent of the ARJ in the standing position is associated with aging in women.

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Title: Pelvic floor morphology in the standing position using upright computed tomography: age and sex differences
Authors: Keiichi Narita
Yoshitake Yamada
Minoru Yamada
Yoichi Yokoyama
Takehiro Nakahara
Masahiro Jinzaki
Publication date: 01-11-2020
Publisher: Springer International Publishing
Keywords: Computed Tomography
Computed Tomography
Published in: International Urogynecology Journal / Issue 11/2020
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-020-04335-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Pelvic floor morphology in the standing position using upright computed tomography: age and sex differences

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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