Prevalence Of Pelvic Floor Dysfunction Research Articles

Comprehensive assessment of the pelvic floor in women: new approaches to the prediction of pelvic organ prolapse

Hypothesis/aims of study. Despite the growing prevalence of pelvic floor dysfunction in women in the postpartum period, there is still no consensus on its etiology and pathogenesis. The prerequisite for serious disorders to occur in the future is the initial stages of pelvic floor dysfunction after childbirth, despite the fact that they occur without severe symptoms and, remaining undiagnosed in a timely manner, further reduce the quality of life of women. Despite the availability of information on causal relationships between childbirth and the appearance of pelvic floor dysfunctions, this knowledge among women of reproductive age is still limited, which warrants further study. A number of methods have been developed to assess the pelvic floor, among which are non-invasive techniques, including a quantitative assessment of the strength of contractions of the pelvic floor muscles, as well as techniques that assess the microcirculation of the vaginal wall. The aim of this study was to evaluate the parameters of the strength of contractions of the pelvic floor muscles and to identify possible correlations between the obtained parameters.
 Study design, materials and methods. The study was carried out using methods for measuring the blood microcirculation of the vaginal wall using laser Doppler blood flowmetry in women after the first birth.
 Results. We obtained indicators of the strength of contractions of the pelvic floor muscles and indicators of the blood microcirculation of the vaginal wall in primary women, and we revealed the dependence of the obtained indicators on the weight and age of the mother, as well as the weight of the fetus at birth.
 Conclusion. The obtained indicators will allow a comprehensive assessment of the pelvic floor in primiparous women, as well as to identify possible risk groups for genital prolapse development in the future.

The Influence of Early Exercise Postpartum on Pelvic Floor Muscle Function and Prevalence of Pelvic Floor Dysfunction 12 Months Postpartum

There is limited knowledge on how exercise impacts the pelvic floor muscles (PFM) and prevalence of stress urinary incontinence (SUI) and pelvic organ prolapse (POP) postpartum. The purpose of this study was to investigate whether early onset of general exercise postpartum negatively affects the PFM and/or increases the risk of SUI and POP 12months postpartum. This study used a prospective cohort design. At 6weeks postpartum, 57 women classified as exercisers (exercising ≥3 times at ≥30min/wk) were compared with 120 nonexercisers (mean age=29 years, SD=4.3). Manometry was used to measure vaginal resting pressure, PFM strength, and PFM endurance, and symptoms of SUI and POP were assessed using questionnaires. Data were presented as standardized beta coefficients (B) and odds ratios (OR). No differences were found between exercisers (n=57) and non-exercisers (n=120) at 6weeks postpartum on vaginal resting pressure (B=-0.04 [95% CI=-3.4 to 2.1]), PFM strength (B=0.03 [95% CI=-4.7 to 7.4]), PFM endurance (B=-0.02 [95% CI=-59 to 46]), or symptoms of SUI (OR=0.51 [95% CI=0.25 to 1.1]) or POP (OR=0.62 [95% CI=0.26 to 1.5]) measured at 12months postpartum. Adjusting for covariates, women with body mass index between 25 and 29.9 and>30 were more likely to report SUI 12months postpartum (OR=2.2 [95% CI=1.0 to 4.7] and OR=3.3 [95% CI=1.2 to 9.4], respectively). Women with physically strenuous occupations were more likely to report POP 12months postpartum (OR=3.0 [95% CI = 1.2 to 7.3]). This study suggests that regular exercise 6weeks postpartum has no negative effect on PFM function or on SUI or POP. Being overweight, however, was associated with more SUI, and women with physically strenuous occupations reported more POP. Results from this study suggest that first-time mothers should be encouraged to start general exercise within the first 6weeks after giving birth. Women at risk for PFD should be advised accordingly and potentially modifiable risk factors should be addressed prior to delivery. First-time mothers are encouraged to talk with a physical therapist about starting regular general exercise in the early postpartum weeks. Health care providers should advise patients on possible preventive measures for women at risk for PFD.

Analysis of the current status of pelvic floor dysfunction in urban women in Xi’an City

Female pelvic floor dysfunction (PFD), a common disease affecting women, has attracted a significant amount of attention in the field of obstetrics and gynecology in recent years. Pelvic floor disorders can induce urinary incontinence, vaginal prolapse and other dysfunction, which seriously affect the quality of life of patients. This study aimed to analyze the current status of PFD in urban women in Xi'an City. A total of 1300 women in the urban area of Xi'an City were selected based on a multi-stage sampling method. A face-to-face questionnaire survey and gynecological examination were carried out, and the prevalence rates of stress urinary incontinence (SUI) and pelvic organ prolapse (POP) and PFD were calculated, Multivariate logistic regression analysis was performed to analyze the risk factors of PFD in urban women in Xi'an City. The effective questionnaire recovery rate was 76.69% (997/1,300). The number of patients with SUI, POP, and SUI combined POP were 124 (55.11%), 64 (28.44%) and 37 (16.44%), respectively, and the prevalence of PFD was 22.57% (225/997). Multivariate logistic regression analysis showed that the risk of PFD in women with vaginal delivery, delivery times ≥2, menopause or prolonged labor was higher than that in women with cesarean section, delivery times of 1, no menopause, or no prolonged labor (P<0.05). The prevalence rate of PFD in urban women in Xi'an City cannot be ignored, especially women who have experienced vaginal delivery, delivered ≥2 children, menopause, or prolonged labor. It may be necessary to prioritize these women so as to actively prevent and control PFD.

A study of prevalence of pelvic floor dysfunction in women attending OPD at a tertiary health care centre

A study of prevalence of pelvic floor dysfunction in women attending OPD at a tertiary health care centre

Evaluation of implant-associated complications after mesh-implants setting in pelvic floor reconstruction

Relevance. According to world data, nowadays prevalence of pelvic floor dysfunction and pelvic organ prolapsed reaches 28%. Most specialists relate pregnancy and delivery to main factors of pelvic prolapse development. Due to lifespan growth frequency of pelvic organ prolapse development increases. According to FDA data annually in the world is made more than 100 000 surgeries with synthetic implants, herewith heavy complications occur in 3.4% and mild complications occur in 14.8% of all cases. About 58% of surgeries are made to women under the age of 60, 13% of patients needs re-intervention during next 5 years. It should be noted that in cases of relapse more than 30% of women need re-intervention. Aim. Evaluate implant-associated complications after mesh-implants setting. Materials and methods. We have made retrospective analysis of mesh-implant use in 458 patients with pelvic organ prolapse in 2018-2018 yy. on the base of Bashkir State Medical University clinic. In order to assess quality of life after mesh-implant setting, we used the following questionnaires: Incontinence Questionnaire Short Form (ICIQ-SF), and also Female Sexual Function Index (FSFI). In order to assess blood microcirculation indices after surgery, we used laser Doppler flowmetry evaluation from anterior vaginal wall. Results. All in all, there were revealed 13 (2.84%) implant-associated complications. In 4 patients ICIQ-SF points were from 3 to 15, which indicates manifestation of urgent urine incontinence signs. According to FSFI questionnaire, sexually active women have 31.5 points. Basic factor, which provokes pelvic floor muscles dysfunction is delivery. Besides, in group of women of reproductive age, pelvic floor muscles dysfunction (PFMD) is associated with the presence of concomitant gynecologic diseases (uterine myoma, endometriosis, ovarian tumors). In the group of women older than 45 years with the presence of somatic pathology - obesity and impaired blood circulation. According to LDF data from anterior vaginal wall women with PFMD have low blood circulation indices, herewith the lowest indices are registered in the group of women older than 45 years.

Prevalence of pelvic floor dysfunction among cervical cancer survivors

Prevalence of pelvic floor dysfunction among cervical cancer survivors

PREVALENCE OF UROGYNECOLOGY SYMPTOMS IN A RURAL POPULATION IN WESTERN-UGANDA

Objectives The primary objective of our study was to determine the prevalence of pelvic floor dysfunction (PFD) in women from rural, Western Uganda. A long term goal would be to encourage the development of training programs for specialists that care for women's pelvic floor concerns, especially those that stem from childbirth or the long-term effects of multiple pregnancies. Methods The study design was a population based cross-sectional survey. The survey administered was the UDI-6 (Urinary Distress inventory-6) with the addition of 2 questions related to obstetrical fistula. 271 women completed the survey during a 5-day medical camp in rural-western Uganda in February 2017. Demographic data was also taken including age, gravida, parity, age at first birth, hysterectomy, completion of high school and menopausal status. Results Thirty-nine percent of women suffered from prolapse symptoms while 30% and 27% complained of stress and urge incontinence symptoms, respectively. Twenty percent of our participants knew 1-2 women suffering from fistula, with 37% citing fistula as a devastating problem in their region. Conclusions Issues of female pelvic medicine are prevalent in rural Uganda and require more education and surgical expertise to be directed towards this area of women's health, especially on a local level. This survey study is helpful in gauging the need for further training in the area of PFD in the form of post-graduate fellowship programs.

Prevalence of Pelvic Floor Dysfunction among Women in South India

Prevalence of Pelvic Floor Dysfunction among Women in South India

Buttock Pain in the Athlete: the Role of Pelvic Floor Dysfunction

Pelvic floor dysfunction is an often overlooked cause of buttock pain in the athlete. Literature on pelvic floor dysfunction in athletes is limited, and therefore, it is frequently missed on evaluation and left untreated. This purpose of this article is to review the role that pelvic floor dysfunction plays in several musculoskeletal conditions experienced by athletes and to discuss pertinent history and physical examination findings that will help healthcare providers identify and treat athletes with pelvic floor dysfunction. Recent studies show the prevalence of pelvic floor dysfunction in athletes is higher than one might expect. Structural changes in pelvic floor muscles have been identified in athletes, although the effect of these changes on pelvic floor function is not clear. Muscles of the pelvic floor are involved in controlling motion at the hip, sacroiliac joint and lumbar spine. Dysfunction in these muscles may contribute to a number of conditions that present with buttock pain. It is important to recognize pelvic floor dysfunction as a potential cause of buttock pain in athletes, particularly in cases that have remained refractory to other conservative therapies.

Распространенность дисфункции тазового дна среди акушеров-гинекологов и факторы, влияющие на выбор терапевтических подходов

Распространенность дисфункции тазового дна среди акушеров-гинекологов и факторы, влияющие на выбор терапевтических подходов

Pelvic floor dysfunction and polycystic ovary syndrome

The purpose of this study was to compare the prevalence of pelvic floor dysfunction (PFD) symptoms in patients with and without polycystic ovary syndrome (PCOS) and among different PCOS phenotypes. This was a case–control study. All participants were assessed using ultrasonography to determine the presence or absence of polycystic ovaries (PCO) and allocated to the case or control group (having healthy females whose husbands were diagnosed with male infertility). The case group was then further subdivided into the three phenotypes according to the presence or absence of menstrual dysfunction (M), hyperandrogenism (HA) and PCO on ultrasonography. Pelvic floor dysfunction was assessed by the Pelvic Floor Distress Inventory-20 (PFDI-20). Briefly, the reported pelvic organ prolapse (POP) symptoms were higher in PCOS group (p = 0.05). The mean PFD score in the HA + M + PCO group was higher compared to other phenotypes although the difference did not reach significant level (p > 0.05). However, there was a significant positive correlation between luteinising hormone (LH) level and the POP symptom portion of the PFDI-20 (p < 0.05). The reported POP symptoms were higher in PCOS group especially in HA + M + PCO phenotype. The findings suggest that higher levels of LH might correlate to symptoms of POP.

Prevalence of Pelvic Floor Dysfunction among Married Women of Udupi Taluk, Karnataka, India

Background: Pelvic floor dysfunction predominantly affects women of all the ages with an increasing prevalence with advancing age. Very few studies on prevalence of urinary incontinence have been conducted in India and none in Udupi taluk. Aim: The aim of this cross-sectional study is to estimate the prevalence of Pelvic Floor Dysfunction among married women of Udupi taluk, Karnataka, India and to evaluate the impact of age, educational qualification, occupation, parity and mode of delivery on pelvic floor dysfunction. Materials and Methods: A cross-sectional study was conducted on 1256 married women using a structured questionnaire. Women were interviewed at their residence using the questionnaire. Institutional ethical committee approval and written informed consent was obtained before the interview. Result: Prevalence of pelvic floor dysfunction was reported to be 21% with 19.02% of the women experiencing urinary incontinence and 1.99% experiencing pelvic organ prolapse. The mean age of the women participated in this study was 45.4 ± 11.8 (ranging between 18-70 years). Eighty seven percent of the women were housewives and 69% of the women had only primary education. Statistically significant association was found between age (p ≤ 0.001), occupation of the women (p ≤ 0.001), presence of urinary incontinence during pregnancy which disappeared after delivery (p=0.009) and occurrence of at least one type of pelvic floor dysfunction. Age, occupation and presence of symptom of urinary incontinence during pregnancy which disappeared after the delivery were reported as the independent predictor of symptoms of pelvic floor dysfunction when analyzed with multivariate logistic regression model. Conclusion: Prevalence of pelvic floor dysfunction among women of Udupi Taluk, Karnataka, India was found to be 21% with age, occupation and presence of symptom of urinary incontinence during pregnancy which disappeared after the delivery as the independent predictor of symptoms of pelvic floor dysfunction.

Pelvic organ prolapse and incontinence in developing countries: review of prevalence and risk factors

Information on the prevalence, risk factors and social consequences of pelvic floor dysfunction (PFD) affecting women in 16 low-income and lower middle-income countries is reviewed. Medline searches were performed for articles dealing with prevalence of PFD. Thirty studies were identified. The mean prevalence for pelvic organ prolapse was 19.7% (range 3.4-56.4%), urinary incontinence (UI) was 28.7% (range 5.2-70.8%) and faecal incontinence (FI) was 6.9% (range 5.3-41.0%). Risk factors for PFD are similar to those in more affluent countries particularly increased age and parity, but additionally, PFD is associated with other factors including poor nutrition and heavy work. The social consequences of PFD conditions can be devastating. Pelvic organ prolapse and urinary and faecal incontinence are significant problems in developing countries. Access to health care to manage these conditions is often limited, and women usually have to live with the consequences for the rest of their lives.

Factors associated with symptoms of pelvic floor dysfunction six years after primary operation of genital prolapse

To determine prevalence of pelvic floor dysfunction (PFD) symptoms in women six years after primary pelvic organ prolapse (POP) surgery and analyze predictive factors for these symptoms. Cross-sectional observational study. Three Swedish hospitals. Women who underwent primary POP surgery in 1993 and had no subsequent POP surgery during the following six years. Clinical data from patient records and a postal questionnaire concerning symptoms of PFD completed in 1999. Prevalence of PFD symptoms, predictive factors. Urinary incontinence episodes > or =weekly were reported by 41%, feeling of vaginal bulging by 18% and solid stool incontinence by 15%. Thirty nine percent were sexually active; 15% refrained completely from sexual activity because of own discomfort or pain and 46% had no sexual activity due to lack of or sick partner. Discomfort or pain during sexual activity was experienced by 42%. Previous incontinence surgery and urinary incontinence prior to POP surgery were predictive factors for urinary incontinence. Anterior repair was protective for the postoperative symptoms of incomplete bladder and bowel emptying and vaginal bulging. Posterior repair was a risk factor for incomplete bowel emptying and solid stool incontinence. The association between posterior repair and discomfort or pain during sexual activity was not significant. The prevalence of PFD symptoms six years after primary POP surgery seemed high. The extent of POP surgery was predictive for postoperative symptoms of urinary and bowel dysfunction but not for discomfort or pain during sexual activity.

Reply to Letter-to-the-Editor: Prevalence of Pelvic Floor Dysfunction in Patients With Interstitial Cystitis. Urology 71: 1231, 2008

Reply to Letter-to-the-Editor: Prevalence of Pelvic Floor Dysfunction in Patients With Interstitial Cystitis. Urology 71: 1231, 2008

Re: Peters KM, Carrico DJ, Kalinowski SE, et al: Prevalence of Pelvic Floor Dysfunction in Patients with Interstitial Cystitis. Urology 70: 16–18, 2007

Dr. Peters and colleagues continue to define pelvic pain and interstitial cystitis (IC). 1 Peters K.M. Carrico D.J. Kalinowski S.E. et al. Prevalence of pelvic floor dysfunction in patients with interstitial cystitis. Urology. 2007; 70: 16-18 Abstract Full Text Full Text PDF PubMed Scopus (101) Google Scholar The examiner identified “levator pain” using digital pressure at the ischial spines. In addition, “patients get referred pain to their low back, suprapubic area, groin, or thighs.” Reply to Letter-to-the-Editor: Prevalence of Pelvic Floor Dysfunction in Patients With Interstitial Cystitis. Urology 71: 1231, 2008UrologyVol. 71Issue 6PreviewWe appreciate the thoughtful comments regarding our paper on pelvic floor dysfunction in patients with interstitial cystitis (IC). We agree that many etiologies may be involved in the pain associated with IC and the bladder may be an “innocent bystander” in a more diffuse process. Many patients with IC suffer from other co-morbidities such as fibromyalgia, chronic fatigue syndrome, vulvodynia, and irritable bowel syndrome.1 It is doubtful that pudendal neuropathy alone would account for all of these co-morbidities. Full-Text PDF

Prevalence of Pelvic Floor Dysfunction in Patients with Interstitial Cystitis

Prevalence of Pelvic Floor Dysfunction in Patients with Interstitial Cystitis

Pelvic Floor Dysfunction in Aging Women

The occurrence of pelvic floor dysfunction may increase steadily during the aging process in women. Pelvic floor dysfunction may be associated with dysfunctions of micturition, defecation, prolapse, and sex. The natural history and mechanism of pelvic floor dysfunction in aged women are not well understood or explored. In this article, we review the effect of age on the prevalence of pelvic floor dysfunction and on the structural and functional changes of the lower urinary tract, anorectum and pelvic floor. Altogether, the aging process has a negative impact on either the function or structure of the lower urinary tract, anorectum and pelvic floor in women.

Prevalence of Pelvic Floor Dysfunction in Patients with Interstitial Cystitis

Objectives To evaluate the prevalence of pelvic floor dysfunction in women with interstitial cystitis (IC). Methods Women with IC and pelvic pain were referred to the Beaumont Women’s Initiative for Pelvic Pain and Sexual Health program. A comprehensive patient history and pelvic examination were completed by a certified women’s health nurse practitioner. Results Seventy women with a mean age of 45 years were evaluated. Of these 70 women 87% had levator pain consistent with pelvic floor dysfunction. The mean levator pain score was 4.48 out of 10. Nearly two thirds of these women (64%) had their pain for 5 years or more, whereas one quarter (24%) had their pain for 1 to 3 years. Half of the women reported irritable bowel syndrome, and more than one third (36%) reported urge urinary incontinence. Conclusions Women with IC may have pelvic floor dysfunction, as noted in this population in which 87% had levator pain upon examination. If pelvic floor dysfunction is diagnosed in IC patients, then therapy targeting the pelvic floor musculature may be considered as part of a multimodality approach to treating IC.

Pelvic floor dysfunction after Burch colposuspension – a comprehensive study. Part II

To evaluate the prevalence of pelvic floor dysfunction (PFD) concerning bowel function at long-term follow-up after Burch colposuspension (Bc) in relation to the bowel function in an age-matched sample of women in the general population. This is a follow-up study of a cohort of 190 patients who underwent Bc in 1980-1988 and 305 age-matched control women without urinary anti-incontinence surgery, randomly selected from the general population. The participants answered a postal questionnaire with detailed questions about the pelvic floor function in 1998. Univariate and multivariate analyses were performed. The patients showed considerable signs of bowel dysfunction compared with the general population in the following aspects: they used the fingers to help emptying the bowel [odds ratio (OR) 3.25 (1.35-7.86)]; had feeling of incomplete emptying of the bowel [OR 2.29 (1.11-4.73)]; felt no warning before passing a motion [OR 3.04 (1.20-7.71)]; had gas incontinence [OR 1.98 (1.17-3.37); had loose stool incontinence [OR 3.67 (1.43-9.42)]; used protection against fecal leakage during daytime [OR 3.22 (1.30-7.95)]; and experienced that the bowel function affected the general well-being adversely [OR 2.15 (1.30-3.56)]. The patients who have undergone colposuspension for stress urinary incontinence have more symptoms of PFD concerning the bowel function than women without urinary anti-incontinence surgery in the general population. This affects the general well-being. A comprehensive concept of multidisciplinary assessment and treatment of PFD should be encouraged.