Abstract
.Near-infrared spectroscopy (NIRS) muscle oxygenation data are relied on in sports medicine. Many women with urinary incontinence (UI) have dysfunctional pelvic floor muscles (PFMs) but their evaluation lacks such measures; a transvaginal NIRS interface would enable the PFM to be interrogated. Paired miniature fiber-optic cables were configured on a rigid foam insert so their emitter detector arrays with an interoptode distance of 20 mm apposed the right and left inner sides of a disposable clear plastic vaginal speculum, and linked to a standard commercial NIRS instrument. Measurement capability was assessed through conduct of three maximum voluntary contractions (MVCs) and one sustained maximum voluntary contraction of the PFM with calculation of HbDiff (½RT), a validated muscle reoxygenation kinetic parameter. In all four asymptomatic controls, mean age 40, mean BMI 21.4, MVCs were associated with changes in PFM oxyhemoglobin (), deoxyhemoglobin (HHb) concentration, and their difference (HbDiff) comparable to those in voluntary muscle sports medicine studies. NIRS data during recovery (reoxygenation) allowed calculation of HbDiff (½RT). New techniques are called for to evaluate UI. This NIRS interface warrants further development as the provision of quantitative reoxygenation kinetics offers more comprehensive evaluation of patients with PFM dysfunction.
Highlights
New techniques to improve health care for women with urinary incontinence (UI) are called for.[1]
For assessment of pelvic floor muscle (PFM) function, which is central to treatment for UI using pelvic floor muscle therapy (PFMT),[3] measurement parameters relating to oxygen recovery kinetics are lacking, yet, in sports medicine such parameters are currently measured using near-infrared spectroscopy (NIRS).[4,5,6]
We describe an application of an established optical technique with the potential to improve health care for women with UI due to PFM dysfunction
Summary
New techniques to improve health care for women with urinary incontinence (UI) are called for.[1] Novel optical systems have been applied in urology, including direct measurement of bladder muscle oxygenation and hemodynamics using near-infrared spectroscopy (NIRS).[2] But, for assessment of pelvic floor muscle (PFM) function, which is central to treatment for UI using pelvic floor muscle therapy (PFMT),[3] measurement parameters relating to oxygen recovery kinetics are lacking, yet, in sports medicine such parameters are currently measured using NIRS.[4,5,6]. Urinary incontinence, defined as involuntary loss of urine,[1] affects the quality of life of 15.7% of U.S women.[7] A wide variety of pathologies lead to UI by causing dysfunction of the PFM, including trauma induced by vaginal birth delivery, neuromuscular compromise due to congenital anomalies or spinal cord injury, and neurologic diseases such as multiple sclerosis and Parkinson’s.8–10. A wide variety of pathologies lead to UI by causing dysfunction of the PFM, including trauma induced by vaginal birth delivery, neuromuscular compromise due to congenital anomalies or spinal cord injury, and neurologic diseases such as multiple sclerosis and Parkinson’s.8–10 Importantly, while the entire PFM complex may be involved, dysfunction can be lateralized to one side or the other; the resulting compromise of muscle strength and differences between the right and left sides cannot be adequately assessed by current clinical measures
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