Abstract
Aims: To investigate the correlation between age and 3-dimensional pelvic floor manometry parameters, sexual function, and urinary status in old post-menopausal versus young nulliparous women. Methods: This was a cross-sectional study. Two groups of young (18 - 40 years) and old (52 - 85 years) nulliparous volunteers completed Pelvic Floor Distress Inventory (PFDI-20), Pelvic Floor Impact Questionnaire (PFIQ-7), and Female Sexual Function Inventory (FSFI-19) and underwent a 3-dimensional pelvic floor manometry. Results: The study included 9 young participants with a mean age of 28.6, and 10 old participants with a mean age of 61.8. All the older participants were postmenopausal and all the young participants were premenopausal. Mean PFDI-20 score was significantly higher in the older group: 52 ± 12 versus 4 ± 4, p= 0.001. Urinary Distress Inventory score (UDI-6, part of PFDI questionnaire) was higher amongst the older group: 28 ± 26 versus 3 ± 8, p= 0.006. All young participants scored zero in their PFIQ-7 while the older participants averaged 31 out of maximal score of 300. While sexual activity was higher in the younger group (89% versus 60%), sexual function assessed through the FSFI-19, was not significantly different between the two groups. Valsalva pressures obtained from manometry measurements were significantly higher in the older group (mean 230 mm Hg versus 161, p= 0.015). Conclusions: Post-menopausal women have higher pelvic floor and urinary symptoms associated with increased Valsalva pressures as measured by vaginal manometry.
Highlights
Age is an established risk factor for both pelvic organ prolapse (POP) and urinary incontinence [1] [2] [3] [4]
While sexual activity was higher in the younger group (89% versus 60%), sexual function assessed through the Female Sexual Function Index (FSFI)-19, was not significantly different between the two groups
Post-menopausal women have higher pelvic floor and urinary symptoms associated with increased Valsalva pressures as measured by vaginal manometry
Summary
Age is an established risk factor for both pelvic organ prolapse (POP) and urinary incontinence [1] [2] [3] [4]. Both of these onerous ailments are linked to pelvic floor muscles’ (PFM) function: PFM strength negatively correlates with risk of POP [1] and its strengthening is found to improve symptoms of urinary incontinence [5]. The levator ani muscles co-activate with the abdominal muscles and the diaphragm to resist the rise in intra-abdominal pressure (Valsalva maneuver) which may lead to vaginal prolapse, urinary and fecal incontinence [12]
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