Symptoms Of Pelvic Floor Disorders Research Articles

The Influence of Successful Treatment of Stress Urinary Incontinence and Pelvic Organ Prolapse on Depression, Anxiety, and Insomnia-A Prospective Intervention Impact Assessment Study.

Introduction: The association between pelvic floor disorders (PFDs) and psychiatric conditions is an area of emerging interest. The causal direction of this relationship, however, remains ambiguous; it is unclear whether PFDs directly contribute to the deterioration of mental health or if pre-existing psychiatric conditions such as depression exacerbate the symptoms of PFDs. This study aimed to evaluate the effects of successful surgical treatment for stress urinary incontinence (SUI) and pelvic organ prolapse (POP) on symptoms of depression, anxiety, and insomnia. Materials and Methods: This investigation focused on patients who underwent successful surgical interventions for SUI and POP. Both subjective and objective symptoms of PFDs, along with psychiatric status, were assessed before and after the surgical procedures. Results: This study found that successful surgical treatment of SUI and POP led to a significant reduction in anxiety scores. Additionally, in patients with SUI, successful treatment was objectively associated with a decrease in the severity of insomnia. Alleviation of symptoms associated with the lower urinary tract, prolapse, and colorectal-anal region following POP surgery was correlated with improvements in depression and anxiety but not insomnia. Subjectively assessed improvements in SUI subjective symptoms were linked to reductions in the severity of depression, anxiety, and insomnia in patients who underwent anti-incontinence surgery. Conclusions: These findings suggest a potential cause-and-effect relationship between PFDs and certain psychiatric disorders, highlighting the importance of successful treatment of PFDs in mitigating symptoms of depression, anxiety, and insomnia.

Psychometric evaluation and cross-cultural adaptation of the Australian Pelvic Floor Questionnaire (APFQ-IR) in Iranian reproductive age women

Pelvic floor disorders (PFDs), as a silent alert, is one of the pervasive debilitating health concerns among women all over the world, such that in developed countries, one in four women, suffers from PFDs. Validity and reliability of the Australian Pelvic Floor Questionnaire (APFQ) has not been determined in Iran, so to determine APFQ’s psychometric characteristics, we decided to conduct this study on women of reproductive age in Tabriz city, Iran. This methodological cross-sectional study was intended to determine the psychometric properties of the Persian version of the APFQ-IR in 5 steps including “translation process, content validity, face validity, construct validity (exploratory and confirmatory factor analyses and examination of ceiling and floor effects) and reliability” on 400 reproductive age women referring to health centers in Tabriz city, Iran, with cluster random sampling method in the period between May 2022 to September 2022. The translation process was done based on two approaches, Dual panel, and Beaton et al.’s five steps. Then, in order to evaluate content validity, face validity, and construct validity, 10 instrument and PFDs experts, 10 women from the target group investigated the instrument's items, and 400 eligible women completed the instrument. Finally, to determine the reliability, two internal consistency methods, (Cronbach's alpha and McDonald's omega) and test–retest method (ICC) were used. In the present study, content validity assessment of APFQ-IR, showed a good level of validity (CVR = 0.96, CVI = 0.94). To assess construct validity, exploratory factor analysis results on 36 items, led to the identification of 4 factors including bladder function, bowel function, prolapse symptom and sexual function, which explained 45.53% of the cumulative variance and indicated the sufficiency of the sample size (Kaiser–Meyer–Olkin = 0.750). Implementing confirmatory factor analysis, (RMSEA = 0.08, SRMR = 0.08, TLI = 0.90, CFI = 0.93, χ2/df = 3.52) confirmed the model fit indices. Finally the internal consistency and reliability was high for the entire instrument (Cronbach’s alpha = 0.85; McDonald's omega (95% CI) = 0.85 (0.83–0.87) and Intraclass Correlation Coefficient (95% CI) = 0.88 (0.74–0.94)). The Persian version of the APFQ-IR, has a good validity and reliability and has acceptable psychometric properties, thus can be used both for research purposes and for clinical evaluation of pelvic floor disorders symptoms in health centers.

Exploring the Process of Women's Confrontation with Symptoms of Pelvic Floor Disorders

Background and Objective: Pelvic floor disorders (PFDs) are defined as defects in the muscle and ligamentous plates that cause disorders in the anterior, medial, and posterior walls. Symptoms of these disorders can affect various aspects of a woman's life. The results of the studies show that there is a lack of knowledge regarding this process. Therefore, the present study aimed to explain the process of women 's confrontation with the symptoms of PFDs . Materials and Methods: This qualitative study was conducted between 2017 and 2020. A total of 38 participants were included using a purposive and theoretical sampling method. To answer the research question, data were collected using semi-structured in-depth interviews. To find out how women coped with the symptoms of PFDs, Corbin and Strauss’ (2015) grounded theory was used. The data were analyzed in four phases, namely 1- analysis of data for concepts, 2- analysis for context, 3- analysis for process, and 4- integration of categories. MAXQDA10 software was used to manage and analyze the qualitative data. Results: In the present study, the main concern of the participants was "deprivation of normal life" and the theory extracted from the data was "symptom management to normalize the situation". This theory was the result of five actions/responses that included mental exploration by observing symptoms and attempting to find reassurance, attempting to hide the illness, trying to resolve marital conflicts, adopting self-management strategies, and actively following up on treatment. Finally, there was a spectrum of consequences ranging from adjustments to the disease to partial recovery. Participants' concerns were related to the "dominance of symptoms in the dimensions of individual and interpersonal life", which included seven sub-concepts. Conclusion: The main finding of this study was the presentation of the theory of "symptom management to normalize the situation", which explained the process in which women faced the symptoms of PFDs. According to this theory, women sought strategies in various contexts in response to their worries and tried to normalize their lives through management.

Prevalence and Risk Factors of Pelvic Floor Disorders After Delivery in Japanese Women Using the Pelvic Floor Distress Inventory: A Retrospective Cohort Study.

Introduction Female pelvic floor disorders (PFDs) include clinical conditions such as urinary and fecal incontinence and pelvic organ prolapse. Disease-specific questionnaires like the Pelvic Floor Distress Inventory-20 (PFDI-20) have facilitated pelvic floor disorder assessment. We aimed to investigate the prevalence of pelvic floor disorders in Japanese women after different modes of delivery and the association of pelvic floor disorders with epidural anesthesia. Material and methods We included 212 women who gave birth at our institution. The PFDI-20 questionnaire (validated in Japanese) was used to evaluate the symptoms of pelvic floor disorders 6-15 months postpartum. Results Out of the 212 postpartum women who participated in this study, 156 (73.6%) had symptoms of pelvic floor disorder; the most prevalent symptom was urinary distress inventory in 114 (53.8%) women [79 (37.3%) of them experienced urine leakage related to increased abdominal pressure]. A comparison of the epidural and non-epidural groups to determine the association between pelvic floor disorder and delivery mode revealed a higher disease burden score of 8.67 points in the epidural group. Conclusion The prevalence of pelvic floor disorder symptoms is relatively high, affecting 156 (73.6%) of 212 women. Accurate diagnosis of women and appropriate and regular follow-up until improvement of their symptoms are crucial. Furthermore, healthcare workers should advise pregnant women on whether to choose vaginal delivery with or without anesthesia. To the best of our knowledge, our study is the first to investigate postpartum pelvic floor disorder in Japan.

Prevalence of pelvic floor dysfunctions in women with endometriosis

Background: Endometriosis is a benign disease that has the potential for agressive tissue-invasion. Endometriosis and pelvic floor disorders (PFD) share common pathogenic mechanisms, but it is unknown whether endometriosis can cause them to develop or induce worsening PFD, including lower urinary tract symptoms, fecal incontinence and constipation. This study aimed to clarify the prevalence of symptoms of PFD in women with endometriosis.

Aversion to Mesh Use in Pelvic Floor Surgery in a Latina Population at the U.S.-Mexico Border.

Limited studies have examined patient aversion to mesh use in pelvic surgery, especially in Latinas. This study aimed to assess aversion to pelvic surgery with mesh for urinary incontinence and pelvic organ prolapse in a sample of Latinas on the U.S.-Mexico border. This was a cross-sectional study of self-identified Latinas with symptoms of pelvic floor disorders, recruited at their initial consultation visit at a single, academic urogynecology clinic. Participants completed a validated survey to assess perceptions of mesh use in pelvic surgery. Participants also completed questionnaires assessing the presence and severity of pelvic floor symptoms and level of acculturation. The primary outcome was aversion to mesh surgery, as indicated by a response of "yes" or "maybe" to the question "Based on what you already know, would you avoid surgery using mesh?" Descriptive analysis, univariate relative risk, and linear regression analysis were completed to identify characteristics associated with mesh avoidance. Significance was assessed and considered at P values <0.05. Ninety-six women were included. Only 6.3% had prior pelvic floor surgery using mesh. Sixty-six percent indicated that they would be likely to avoid pelvic surgery that uses mesh. Only 9.4% indicated that they obtained information regarding mesh directly from medical professionals. Levels of concern regarding the use of mesh varied widely (29.2% not worried, 19.1% somewhat worried, 16.9% very worried). Higher percentages of "more acculturated" participants indicated a desire to avoid mesh surgery (58.7% vs 27.3%, P < 0.05). In this Latina population, a majority of patients indicated an aversion to using mesh in pelvic surgery. Few patients obtained information regarding mesh directly from medical professionals, relying instead on nonmedical sources.

Effects of preoperative intravaginal estrogen on pelvic floor disorder symptoms in postmenopausal women with pelvic organ prolapse

Menopause and the decline in systemic estrogen are associated with the development of pelvic floor disorders, such as prolapse, urinary incontinence, overactive bladder, and vulvovaginal atrophy symptoms. Past evidence suggests that postmenopausal women with symptomatic prolapse gain benefit from the preoperative application of intravaginal estrogen, but it is unknown whether they would experience improvement in other pelvic floor symptoms when treated with intravaginal estrogen. This study aimed to determine the effects of intravaginal estrogen (compared with placebo) on stress and urgency urinary incontinence, urinary frequency, sexual function and dyspareunia, and vaginal atrophy symptoms and signs in postmenopausal women with symptomatic prolapse. This was a planned ancillary analysis of a randomized, double-blind trial, "Investigation to Minimize Prolapse Recurrence Of the Vagina using Estrogen," which included participants with ≥stage 2 apical and/or anterior prolapse scheduled for transvaginal native tissue apical repair at 3 US sites. The intervention was 1 g conjugated estrogen intravaginal cream (0.625 mg/g) or identical placebo (1:1), inserted nightly for 2 weeks and then twice weekly for ≥5 weeks total before surgery and continued twice weekly for 1 year postoperatively. For this analysis, question responses were compared from participants' baseline and preoperative visits: lower urinary tract symptoms (Urogenital Distress Inventory-6 Questionnaire); sexual health questions, including dyspareunia (Pelvic Organ Prolapse/Incontinence Sexual Function Questionnaire-IUGA-Revised); and atrophy-related symptoms (dryness, soreness, dyspareunia, discharge, and itching; each scored 1-4, 4 being quite a bit bothersome). Masked examiners assessed vaginal color, dryness, and petechiae (each scored 1-3, total range 3-9, with 9 being the most estrogenized appearing). Data were analyzed by intent to treat and "per protocol" (ie, those adherent with ≥50% of expected intravaginal cream use, per objective tube before and after weights). Of 199 participants randomized (mean age of 65 years) and contributing baseline data, 191 had preoperative data. The characteristics were similar between groups. Total Urogenital Distress Inventory-6 Questionnaire scores showed minimal change during this median time of 7 weeks between baseline and preoperative visits, but for those with at least moderately bothersome baseline stress urinary incontinence (32 in the estrogen group and 21 in the placebo group), 16 (50%) in the estrogen group and 9 (43%) in the placebo group showed improvement (P=.78). In addition, 43% of participants in the estrogen group and 31% of participants in the placebo group showed improvement in urgency urinary incontinence (P=.41), and 41% of participants in the estrogen group and 26% of participants in the placebo group showed improvement in urinary frequency (P=.18). There was minimal change in the Pelvic Organ Prolapse/Incontinence Sexual Function Questionnaire-IUGA-Revised scores among sexually active women; dyspareunia rates did not differ between intravaginal estrogen and placebo at the preoperative assessment: 42% and 48%, respectively (P=.49). The maximum score for most bothersome atrophy symptom (among those with baseline symptoms and adherent to study cream) improved slightly more with intravaginal estrogen (adjusted mean difference,-0.33 points; 95% confidence interval,-0.98 to 0.31), but this was not statistically significant (P=.19). However, on examination, among adherent participants, objective signs of atrophy were more improved with intravaginal estrogen treatment (+1.54 vs+0.69; mean difference, 0.85; 95% confidence interval, 0.05-1.65; P=.01). Despite objective changes in the vaginal epithelium consistent with increased estrogenization among drug-adherent participants, the results were inconclusive regarding whether 7 weeks of preoperative intravaginal estrogen cream in postmenopausal women with symptomatic pelvic organ prolapse was associated with improved urinary function, sexual function, dyspareunia symptoms, and other symptoms commonly attributed to atrophy. Additional study is needed.

Effects of vaginal estrogen on pelvic floor disorder symptoms in postmenopausal women with prolapse undergoing surgery

Effects of vaginal estrogen on pelvic floor disorder symptoms in postmenopausal women with prolapse undergoing surgery

Early adulthood and current physical activity and their association with symptoms of pelvic floor disorders in middle-aged women: An observational study with retrospective physical activity assessment.

To investigate associations of early and middle adulthood physical activity (PA) with symptoms of pelvic floor disorders (PFDs), i.e. stress urinary incontinence (SUI), urge urinary incontinence (UUI), faecal incontinence (FI), constipation or defecation difficulties (CDDs) and feeling of pelvic organ prolapse (POP) among middle-aged women. A cross-sectional, observational study with retrospective PA assessment. University Research Laboratory. A random population sample of 1098 Finnish women aged 47-55 years. Early adulthood PA, current PA, and demographic and gynaecological variables were assessed using self-report questionnaires. Logistic regression analyses were applied to study associations of PA variables with symptoms of PFDs. Potential confounding effects of demographic and gynaecological variables were controlled in multiple logistic regression models. Structured questionnaire-assessed retrospective PA assessment at the age of 17-29 years, current PA at middle age, and prevalence of symptoms of CDD, FI, POP, SUI and UUI. Current PA was not independently associated with the occurrence of the symptoms of PFDs. Middle-aged women with an early adulthood history of competitive sports were more likely to experience symptoms of UUI (OR2.16, 95%CI 1.10-4.24, p=0.025) but not symptoms of SUI, FI, CDD or POP, whereas women with a history of regular PA were more likely to experience symptoms of FI (OR4.41, 95%CI 1.05-18.49, p=0.043) but no other symptoms of PFDs. Competitive sports during early adulthood may increase the risk of UUI in middle age. Regular PA during early adulthood may increase the risk of FI.

Symptom and Anatomical Phenotypes Provide Insights Into Interactions of Prolapse Symptoms and Anatomy.

Women pursue treatment to relieve symptoms, while surgeons repair anatomy, underlining the importance of the relationship between symptoms and anatomy. We hypothesized different anatomical and symptom phenotypes associated with pelvic organ prolapse (POP). Our objective was to investigate prevalence of phenotypes to explore associations of symptoms with anatomical defects. We defined 420 anatomical phenotypes from combinations of POP Quantification parameters and 128 symptom phenotypes from symptoms described by condition-specific questionnaires (Pelvic Floor Disorders Inventory, Short Form of the Personal Experience Questionnaire). We applied these to an anonymized database of 719 subjects with symptomatic pelvic floor disorders. Bar graphs were used to illustrate the distribution of anatomical and symptom phenotypes, as well as anatomical phenotypes of patients with specific symptoms. We then used biclustering analysis with the multiple latent block model, to identify patterns of clustered groups of subjects and features. The most common symptom phenotypes have multiple (3-5) symptoms. A third of the theoretical anatomical phenotypes existed in our cohort. Bar graphs for specific symptom composites demonstrated unique distributions of anatomical phenotypes suggesting associations between anatomy and symptoms. Biclustering converged on 2 subject clusters (C1, C2) and 8 feature clusters. Cluster 1 (68%) represented a younger subpopulation with lower stage POP, more stress urinary incontinence and sexual dysfunction (P < 0.001 all). Cluster 2 had more protrusion (P < 0.001) and obstructed voiding (P = 0.001). Features that clustered together, such as stress urinary incontinence and sexual dysfunction, may represent underlying relationships. We demonstrated a relationship between locations of anatomical POP and certain symptoms, which may generate new hypotheses and guide clinical decision making.

Barriers and Promotors to Health Service Utilization for Pelvic Floor Disorders in the United States: Systematic Review and Meta-analysis of Qualitative and Quantitative Studies

(Abstracted from Urogynecology 2022;28:574–581) Pelvic floor disorders (PFDs), such as pelvic organ prolapse (POP), anal incontinence (AI), and lower urinary tract symptoms (LUTSs), affect approximately 1 in 4 women in the United States. Many women endure PFD symptoms without seeking care.

Assessing Rectocele Depth and Its Association with Symptoms of Pelvic Floor Disorders Using 2D Transperineal Ultraound

Other SectionsAbstractINTRODUCTIONMETHODSRESULTSDISCUSSIONCONCLUSIONCONFLICTS OF INTERESTFigureTableReference

Do Sexually Abstinent Women have more Pelvic Floor Disorders? A Cross Sectional, Population Based Study

Introduction and hypothesis: The aims were to establish the prevalence of sexually abstinent women because of Pelvic Floor Disorders (PFDs) in parous women, and to examine if abstinence was associated with symptoms of PFDs or functional anatomy of the pelvic floor.

Barriers and Promotors to Health Service Utilization for Pelvic Floor Disorders in the United States: Systematic Review and Meta-analysis of Qualitative and Quantitative Studies.

We need a systematic approach to understanding health service utilization behavior in women with pelvic floor symptoms in the United States. The aim of this study was to determine the prevalence of pelvic floor care utilization and identify its barriers and promotors using Andersen's model, which theorizes care-seeking behavior with individual care needs, resources, predispositions, and macrostructures. This was a systematic search of studies on care-seeking patterns in women with symptomatic pelvic floor disorders, which included pelvic organ prolapse, lower urinary tract symptoms, and anal incontinence. We then performed meta-analyses with random-effects models and descriptive analysis to determine utilization rate and the impact of each identified determinant. The pooled utilization rate was 37% (95% confidence interval [CI], 30%-45%). Determinants were identified across all domains except at the macrostructure level. For individual care needs, increased symptom severity or duration and a history of depression (odds ratio [OR], 1.27; 95% CI, 1.07-1.51) were associated with higher utilization. In the resources domain, having social support and established primary/secondary care were promotors, whereas higher income and employed status trended as barriers. Under predispositions, age ≥50 years (OR, 1.29; 95% CI, 1.05-1.60), and pelvic floor awareness were associated with utilization, whereas Asian (OR, 0.60; 95% CI, 0.51-0.72) and Black (OR, 0.77; 95% CI, 0.55-1.08) women as well as women experiencing fear, misinformation, or normalization of pelvic floor disorders had decreased utilization. This review identified a low utilization rate for pelvic floor care and revealed multilayered, actionable items affecting care-seeking behavior. It highlights the need for more inclusive and multifaceted approaches in future pelvic floor disparity research and equity interventions.

Prevalence and the degree of distress of pelvic floor disorders symptoms in women seeking primary health care at Ismailia governorate, Egypt

Pelvic Floor Disorders (PFDs) are common debilitating conditions among women worldwide, which have had a negative effect on women’s quality of life and can be particularly bothersome. The objective of this study was to assess the prevalence of PFDs and the degree of bother of PFDs symptoms among women seeking primary health care. A cross sectional study was conducted in primary health care settings affiliated with Ministry Of Health and Population (MOHP) in Ismailia city, Egypt. The study was carried out from October 2019 to May 2020 on 500 women who were recruited by two-stage cluster random sampling. A semi-structured questionnaire was used to collect data on demographic, and reproductive characteristics. PFD was assessed based on symptoms reporting by women. A short-form version of the Pelvic Floor Distress Inventory (PFDI-20) was used to assess the severity of pelvic floor symptoms. The prevalence of pelvic floor disorder was (41%), with over active bladder being the most prevalent type (32.8 %) followed by stress urinary incontinence (29.2%). Age, obesity, vaginal delivery 4 times or more, caesarean delivery, and history of abortion were positive predictors of PFD prevalence (p&lt;0.001). More than one third (35.6%) of women who had urinary incontinence and (81.8 %) of women who had pelvic organ prolapsed reported their symptoms as severe. The study highlights the magnitude of pelvic floor disorder prevalence. This stresses for urgent action to improve prevention, diagnosis and treatment services to decrease the suffering of women from pelvic floor disorders.

An evaluation of pelvic floor disorders in a public and private healthcare setting.

The objectives were to determine whether a difference exists in the duration of pelvic floor disorder (PFD) symptoms among patients presenting to urogynecologists in two healthcare systems: private and county; and to elucidate differences in baseline characteristics, type of PFDs, symptom severity and management, stratified by healthcare plans. A multi-center retrospective study was conductedincluding new patients presenting to three urogynecology clinics between March 2016 and May 2018: one private clinic (site A) and two public clinics in the same county healthcare system (sites B and C). Baseline data included age, race, BMI, parity, and comorbidities. Primary outcome was "time to presentation" defined as PFD duration in months. Secondary outcomes were symptom severity and PFD management, analyzed by healthcare setting and insurance type. A total of 1,055 private and 439 public patients were included. Patients in the public setting were younger (54 vs 61 years, p<0.001), largely Hispanic (76% vs 14%, p<0.001), of higher parity (4 vs 3, p=0.001), and had more comorbidities, with a predominance of county-funded healthcare plans. There was no difference in duration of symptoms between the public and private groups respectively (54 vs 56 months, p=0.94). Patients in the public setting had more severe urinary incontinence (3 vs 2 pads/day, p<0.001) and prolapse (stages 3-4, 71% vs 61%, p=0.004); however, they had lower rates of surgical management for stress incontinence and prolapse. Differences in fecal incontinence could not be evaluated owing to small sample size. Public patients presented younger with more severe symptoms but had lower rates of surgery for PFDs traditionally managed surgically.

434 Effect of second pregnancy and mode of delivery on the prevalence of symptomatic pelvic floor disorders - longitudinal study

Introduction: Pregnancy and childbirth are one of the main risk factors for developing pelvic floor disorders (PFD). Mathematical modeling suggests key role of the first delivery yet we have limited epidemiological data describing subsequent deliveries. Objective: Prospective longitudinal study focused on assessment of PFD after two consecutive deliveries. Methods: Study visits were arranged 1 year after the first (I.D) and the second delivery (II.D). Patients were asked about PFD, specifically stress urinary incontinence (SUI).

Aversion to mesh use for pelvic floor surgery in a latina population at the U.S.-mexico border

The objective of this study was to characterize the perspectives of a sample of Latina women on the U.S.-Mexico border regarding mesh use in pelvic surgery for urinary incontinence and pelvic organ prolapse. Additionally, we sought to determine factors associated with level of concern with, or aversion to, future mesh surgery. This was a cross-sectional study of self-identified Latina women with symptoms of pelvic floor disorders, recruited at their initial visit, at a single academic Urogynecology clinic. Subjects completed a validated survey assessing perceptions of mesh use in pelvic surgery in English or Spanish. They completed validated questionnaires assessing presence and severity of pelvic floor disorders and items on the Short Acculturation Scale for Hispanics (SASH). A chart review collected participant history and characteristics. Primary outcomes were level of concern regarding possible future mesh surgery and aversion to future surgery. Descriptive analysis, univariate relative risk, and linear regression analyses were completed. A p-value of <0.05 was considered statistically significant. Ninety-six women were included in the primary outcome analysis. Average age of participants was 54.5 years. Approximately 60% had symptoms of prolapse (stage 1 26.7%, stage 2 45.6%, stage 3 6.7%), 64% had a negative cough stress test, and 6.3% had prior pelvic floor surgery utilizing mesh. About 66% of participants indicated they would be likely to avoid pelvic surgery utilizing mesh. Prior hysterectomy was more prevalent among participants who would avoid mesh surgery (50.8% versus 27.3%, p 0.03). Only 9.4% obtained information regarding mesh directly from medical professionals. Level of concern regarding the use of mesh varied widely (29.2% not worried, 19.1% somewhat worried, 16.9% very worried). There were no significant differences in the median summary scores for the PFDI-20 (median score 39.6 vs 32.9, p 0.08) or PFIQ-7 surveys (median score 57.1 vs 61.8, p 0.43) among participants who would or would not avoid mesh surgery. Median SASH scores were significantly higher in participants likely to avoid mesh surgery (3.0 vs 2.0, p 0.01), coinciding with higher percentages of acculturation in this group compared to participants who would not avoid mesh surgery (“more acculturated” 58.7% vs 27.3%, p <0.05). This result remained the only statistically significant finding on regression analysis. In this Latina cohort, we found a large proportion of patients indicated an aversion to the use of mesh in pelvic surgery. This decision appeared to be significantly influenced by their level of acculturation. Few patients reported obtaining information regarding mesh directly from medical professionals. Future studies can identify methods of increasing patient education regarding the use of mesh and to dispel myths or misconceptions in our patient population.

Presentation and treatment pattern differences between asian and white patients with pelvic floor disorders

Several epidemiological studies demonstrate that Asian/Asian American women have lower rates of pelvic floor disorders (PFDs) and care seeking behavior than white women, but little is reported about PFD symptoms or treatment preferences in this population. Our objective was to describe and compare the characteristics, symptoms, diagnoses, and treatment choices between Asian and white patients. This was a retrospective chart review of patients presenting for urogynecologic care at a tertiary care urban academic center between January 2019 and January 2020. The hospital's data warehouse identified age-matched within 1 year, self-identified Asian and white patients in a 1:3 ratio and collected their demographics and questionnaire data. Each chart was reviewed for systematically documented variables: chief complaint, goals for the visit, primary diagnosis at end of visit, and treatment chosen. Goals were coded into categories: symptom, lifestyle, emotional, information seeking, or others. Primary diagnoses were coded as pelvic organ prolapse (POP), stress urinary incontinence (SUI), mixed urinary incontinence (MUI), overactive bladder (OAB), myofascial pelvic floor dysfunction (MPFD), and other (e.g., anal incontinence and other gynecologic conditions). Treatments were categorized into expectant, behavioral, medical, or procedural/surgical. SPSS was used to perform descriptive statistical analysis of the overall cohort and diagnosis sub-groups. Eighty-five Asian and 255 age-matched white patients were identified. There was no difference in BMI, Charlson Comorbidity Index, or parity between groups (Figure 1). Asian patients were less likely to have a history of anxiety (20.0% vs 45.5%, p=<0.001) and more likely to be sexually active (65.1% vs 50.8%, p=0.025) than white patients. There was no difference in PFDI score or POP-Q stage at presentation to care. The two most common diagnoses in Asian women were MUI (31.8%) and POP (20.0%), while the most common in white women were MPFD (22.4%) and other (22.0%), p=0.008. There were no differences in treatment goals or preferences between groups with the majority in both groups looking to treat a symptom and less than one quarter in both groups choosing surgical/procedural treatments. In sub-analysis by diagnosis, only the POP subgroup demonstrated clinically relevant differences. Asian patients with POP were more likely to be sexually active (70.6% vs 37.1%, p=0.024) and reported less bother on the POPDI (16.7 [IQR 10.4-39.6] vs 41.7 [IQR 16.7-60.4], p=0.031) despite having the same median POPQ stage. Compared to white women presenting for urogynecologic care, Asian women were more likely to present with MUI and POP; however, they reported similar treatment goals and choose similar broad treatment categories. They were also less bothered by similar stages of POP.

Symptomatic pelvic floor disorders and its associated factors in South-Central Ethiopia.

IntroductionPelvic floor disorders (PFD) are gynecologic health problems containing a wide variety of clinical problems; the most prevalent problems are pelvic organ prolapse, fecal incontinence, and urinary incontinence. It is a significant women’s health problem for both developed and developing countries. One in five women in Ethiopia experiences at least one major type of pelvic floor disorders. Despite the severity of the problem, due attention was not given, and no study has been conducted on pelvic floor disorders in the Gurage Zone.ObjectiveTo determine the prevalence and associated factors of symptomatic pelvic floor disorders among women living in Gurage Zone, SNNPR, Ethiopia, 2020.MethodologyCommunity-based cross-sectional study was conducted from February to March 2020 among 542 women residing in the Gurage Zone. A multi-stage sampling method was used to select the participants. Interviewer administered, pretested questionnaires containing questions related to pelvic organ prolapse, urinary, and fecal incontinence was used. The urinary incontinence severity index questionnaire was used to assess the severity of urinary incontinence. Epi-Info x7 was used to record data, and SPSS was used to analyze the data. Binary logistic regression with 95% CI was used to explore the relationship between PFD and other independent variables. After multivariable logistic regression analysis variables with P-value less than 0.05 was used to determine significant association.ResultA total of 542 participants were included in this study. Overall, 41.1% of the participants reported one or more symptoms of pelvic floor disorders. Urinary incontinence had the highest prevalence (32.8%), followed by pelvic organ prolapse (25.5%) and fecal incontinence (4.2%). History of weight lifting >10 Kg (AOR = 3.38; 95% CI: 1.99, 5.72), ≥5 vaginal delivery (AOR = 11.18; 95% CI: 1.53, 81.58), and being in menopause (AOR = 3.37; 95% CI: 1.40, 8.07) were identified as possible contributing factors in the development of a pelvic floor disorders.ConclusionThe prevalence of symptomatic PFD was higher compared to other similar studies in Ethiopia. Heavy weight lifting, repetitive vaginal deliveries and menopause were factors significantly associated with PFD. Expansion of technologies and building basic infrastructures, health education on kegel exercise and promotion of family planning should be considered as a prevention strategy.