Document Detail

Does vaginal closure force differ in the supine and standing positions?
MedLine Citation:
PMID:  15902185     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: This study was undertaken to quantify resting vaginal closure force (VCF(REST)), maximum vaginal closure force (VCF(MAX)), and augmentation of vaginal closure force augmentation (VCF(AUG)) when supine and standing and to determine whether the change in intra-abdominal pressure associated with change in posture accounts for differences in VCF. STUDY DESIGN: Thirty-nine asymptomatic, continent women were recruited to determine, when supine and standing, the vaginal closure force (eg, the force closing the vagina in the mid-sagittal plane) and bladder pressures at rest and at maximal voluntary contraction. VCF was measured with an instrumented vaginal speculum and bladder pressure was determined with a microtip catheter. VCF(REST) was the resting pelvic floor tone, and VCF(MAX) was the peak pelvic floor force during a maximal voluntary contraction. VCF(AUG) was the difference between VCF(MAX) and VCF(REST). T tests and Pearson correlation coefficients were used for analysis. RESULTS: VCF(REST) when supine was 3.6 +/- 0.8 N and when standing was 6.9 +/- 1.5 N--a 92% difference (P < .001). The VCF(MAX) when supine was 7.5 +/- 2.9 N and when standing was 10.1 +/- 2.4 N--a 35% difference (P < .001). Bladder pressure when supine (10.5 +/- 4.7 cm H2O) was significantly less (P < .001) than when standing (31.0 +/- 6.4 cm H2O). The differences in bladder pressure when either supine or standing did not correlate with the corresponding differences in VCF at rest or at maximal voluntary contraction. The supine VCF(AUG) of 3.9 +/- 2.7 N, was significantly greater than the standing VCF(AUG) of 3.3+/-1.9 N. CONCLUSION: With change in posture, vaginal closure force increases because of higher intra-abdominal pressure and greater resistance in the pelvic floor muscles.
Daniel M Morgan; Gurpreet Kaur; Yvonne Hsu; Dee E Fenner; Kenneth Guire; Janis Miller; James A Ashton-Miller; John O L Delancey
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  192     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-05-19     Completed Date:  2005-06-24     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1722-8     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, Pelvic Floor Research Group, University of Michigan Medical School, Ann Arbor 48109, USA.
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MeSH Terms
Equipment Design
Gynecology / instrumentation
Middle Aged
Muscle Contraction / physiology*
Pelvic Floor / physiology*
Posture / physiology*
Reference Values
Supine Position*
Surgical Instruments
Urinary Bladder / physiology
Vagina / physiology*
Grant Support
P50 HD044406-01/HD/NICHD NIH HHS; P50 HD044406-010002/HD/NICHD NIH HHS; P50 HD044406-02/HD/NICHD NIH HHS; P50 HD044406-03/HD/NICHD NIH HHS; P50 HD44406/HD/NICHD NIH HHS; R01 HD 38665/HD/NICHD NIH HHS; R01 HD038665-01/HD/NICHD NIH HHS; R01 HD038665-02/HD/NICHD NIH HHS; R01 HD038665-03/HD/NICHD NIH HHS; R01 HD038665-04/HD/NICHD NIH HHS; R01 HD038665-05/HD/NICHD NIH HHS; R01 HD041123-01/HD/NICHD NIH HHS; R01 HD041123-02/HD/NICHD NIH HHS; R01 HD041123-03/HD/NICHD NIH HHS; R01 HD041123-04/HD/NICHD NIH HHS; R01HD38665-05/HD/NICHD NIH HHS

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