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Akesson C, Richards EG, Yao M, Ross J, Grima J, May L, Roversi G, Ferrando CA. Pelvic Floor Dysfunction Among Persons With Marfan and Loeys-Dietz Syndrome. UROGYNECOLOGY (PHILADELPHIA, PA.) 2024; 30:781-789. [PMID: 38517279 DOI: 10.1097/spv.0000000000001481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
IMPORTANCE Connective tissue disorders are proposed in the literature to be predisposing risk factors for pelvic floor disorders. Prior data characterizing the prevalence of and symptom burden related to pelvic floor disorders are limited for individuals with Marfan syndrome and are nonexistent for those with Loeys-Dietz syndrome. OBJECTIVE The objective of this study was to determine the prevalence and severity of symptoms related to pelvic floor disorders among individuals with Marfan syndrome and Loeys-Dietz syndrome using the Pelvic Floor Distress Inventory-20 (PFDI-20). STUDY DESIGN In this cross-sectional study, a survey including the PFDI-20 was administered to biologically female individuals older than 18 years with a confirmed diagnosis of Marfan syndrome or Loeys-Dietz Syndrome. Respondents were solicited through the websites, email lists, and social media forums of The Marfan Foundation and The Loeys-Dietz syndrome Foundation. RESULTS A total of 286 respondents were included in the final analysis, 213 with Marfan syndrome and 73 with Loeys-Dietz syndrome. The median PFDI-20 score of the cohort was 43.8. Individuals with Loeys-Dietz syndrome had higher PFDI-20 scores and were more likely to have established risk factors for pelvic floor disorders that correlated with their PFDI-20 scores compared with those with Marfan syndrome. CONCLUSIONS Respondents with Marfan syndrome and Loeys-Dietz syndrome experience a high burden of symptoms related to pelvic floor disorders. Despite the similar pathophysiology and clinical manifestations of these disorders, there were differences in PFDI-20 responses that may suggest that these diseases differ in the ways they affect the pelvic floor.
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Affiliation(s)
- Cydni Akesson
- From the Cleveland Clinic Lerner College of Medicine
| | | | - Meng Yao
- Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, OH
| | - James Ross
- Jersey Shore University Medical Center, Neptune Township, NJ
| | | | - Lauren May
- The Marfan Foundation, Port Washington, NY
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Zhu L, Li X, Zhou C, Tong Y, Liu Z, Huang C. Pelvic floor dysfunction after colorectal cancer treatment is related to physical and psychological health and body image: A cross-sectional study. Eur J Oncol Nurs 2023; 67:102425. [PMID: 37871415 DOI: 10.1016/j.ejon.2023.102425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/23/2023] [Accepted: 09/29/2023] [Indexed: 10/25/2023]
Abstract
PURPOSE Pelvic floor dysfunction (PFD) often occurs in patients with colorectal cancer (CRC), which can affect their quality of life. However, the precise factors that related to PFD in CRC patients remain elusive. The main objective of this study was to identify the variables associated with PFD following CRC treatment and establish a foundation for the development of a tailored rehabilitation plan specific to this population. METHODS The classification of 149 patients with CRC was conducted according to the type of medical treatment they underwent. PFD was evaluated using the Urogenital Distress Inventory 6 (UDI-6) and Colorectal-Anal Distress Inventory 8 (CRADI-8) questionnaires. The study employed the Short form 36 health survey (SF-36) and Body Image Scale (BIS) to evaluate physical and psychological health as well as body image disorders. The connection between PFD and independent variables was determined through logistic regression analyses. RESULTS Of all patients, more than 50% reported experiencing dysfunction, with the highest proportion observed in the PRT (primary radiotherapy) group. The LRR/RR (robotic-assisted colorectal resection or laparoscopic colorectal resection) group revealed a significant association between high BMI (Body Mass Index) and alcohol consumption with PFD. Moreover, in the PRT group, PFD was correlated with poorer physical condition (OR = 0.94, 95% CI = [0.88-1.00]). CONCLUSIONS PFD is a commonly complained-about issue among patients with CRC. Early intervention targeted towards these factors may aid in the alleviation of associated distress and contribute towards the individualization of CRC rehabilitation programs, consequently improving the quality of life for patients.
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Affiliation(s)
- Liping Zhu
- Department of Rehabilitation Medicine, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Xuhong Li
- Department of Rehabilitation Medicine, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Chengyu Zhou
- Department of Rehabilitation Medicine, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yao Tong
- Department of Rehabilitation Medicine, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhaoxue Liu
- Department of Rehabilitation Medicine, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Chenghui Huang
- Department of Oncology, The Third Xiangya Hospital, Central South University, Changsha, China.
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Pelvic floor dysfunction and its influencing factors during radiotherapy in cervical cancer survivors: A cross-sectional study. Eur J Oncol Nurs 2023; 64:102307. [PMID: 37141663 DOI: 10.1016/j.ejon.2023.102307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/05/2023] [Accepted: 03/10/2023] [Indexed: 03/22/2023]
Abstract
PURPOSE Radiotherapy can negatively affect the pelvic floor function of patients with cervical cancer; however, the impact of different radiotherapy times and other related factors on pelvic floor function in cervical cancer survivors during radiotherapy remains unclear. We aimed to investigate the status of pelvic floor dysfunction (PFD) in cervical cancer survivors during radiotherapy and to analyze the factors influencing PFD. METHODS In this cross-sectional study, a convenience sampling method was used to recruit cervical cancer survivors undergoing radiotherapy from January 2022 to July 2022 at a tertiary first-class hospital located in northeastern China. The Pelvic Floor Distress Inventory-Short Form 20 was used for participants' self-report of their PFD during radiotherapy. RESULTS Data from 120 cervical cancer survivors were included in this study. The results showed that the mean PFDI-20 total score was 32.69 ± 7.76. Multiple stepwise linear regression analysis showed that 56.9% of the variance in PFD was explained by age (β = 0.25, p < 0.001), body mass index (β = 0.32, p < 0.001), recurrence (β = 0.29, p < 0.001), number of radiotherapy sessions (β = 0.39, p < 0.001), and number of deliveries (β = 0.35, p < 0.001). CONCLUSION It is important to pay more attention to the PFD status of cervical cancer survivors receiving radiotherapy. Future therapeutic approaches should involve early identification of relevant risk factors early to provide patients with personalized care at different stages of radiotherapy for reducing their discomfort and improving their health-related quality of life.
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Zhu Y, Wei J, Yang X, Zhu W, Zhang W. Investigation on prevalence and risk factors associated with genitourinary syndrome of menopause in middle-aged and older women in Beijing community: a cross sectional study. BMC Womens Health 2022; 22:558. [PMID: 36585649 PMCID: PMC9801667 DOI: 10.1186/s12905-022-02099-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 11/29/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Genitourinary syndrome of menopause (GSM) comprises genital symptoms (dryness, burning, itching, irritation, bleeding), sexual symptoms (dyspareunia and other sexual dysfunctions) and urinary symptoms (dysuria, frequency, urgency, recurrent urinary infections) associated with menopause. To avoid invasive testing and painful physical examinations, validated questionaries, which can assess the prevalence and risk factors associated with symptoms of GSM. We aimed to investigate the prevalence and risk factors associated with GSM in middle-aged and older women in the communities of Beijing, China. METHODS A cross-sectional, questionnaire study was performed among 35-70 years old Chinese woman. Vaginal health index score and urinary distress inventory (UDI-6) was used to evaluate vulvovaginal atrophy (VVA) and urinary incontinence (UI). Stages of pelvic organ prolapse (POP) was measured during gynecological examination with POP-Q system. Mean ± standard deviation (SD) and proportion/percentages were used to summarize continuous and categorial variables respectively. The Bonferroni method was used to adjust for multiple comparisons. RESULTS A total of 2702/3000 participants completed the questionnaire survey. The mean ± SD age of participants was 53.7 ± 7.0 years and prevalence of VVA among participants was 34.8% (941/2702). In UDI-6 questionnaires total 47.5% (1284/2702) participants reported experiencing urinary incontinence (UI). Further, POP was highly prevalent in anterior vaginal wall 38.9% (1050/2702) followed by posterior vaginal wall 25.3% (683/2702) and uterine 22.2% (599/2702). Besides, multiple logistic regression analysis inferred older age (45-54 years [OR (95% CI): 3.38 (2.03, 5.64)]; 55-64 years [OR (95% CI): 8.63 (5.09, 14.64)]), menopause [OR (95% CI): 2.20 (1.71, 2.85)] and Faecal Inconsistence (FI) [OR (95% CI): 1.31(1.00, 1.72)] as independent risk factors for VVA. CONCLUSIONS Our study evidenced that GSM is prevalent in old age Chinese women. GSM is related with UI, POP and VVA. Further older age, menopause and FI were risk factors associated with VVA. Our findings could help health care personnel to get a comprehensive overview of factors associated with VVA and urinal distress, which may facilitate early detection and prevention of GSM.
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Affiliation(s)
- Ye Zhu
- grid.411634.50000 0004 0632 4559Department of Obstetrics and Gynecology, Peking University People’s Hospital, Xicheng District, No. 11, Xizhimen South Street, Beijing, 100044 China
| | - Junxiu Wei
- grid.459324.dDepartment of Obstetrics and Gynecology, Affiliated Hospital of Hebei University, Baoding, China
| | - Xin Yang
- grid.411634.50000 0004 0632 4559Department of Obstetrics and Gynecology, Peking University People’s Hospital, Xicheng District, No. 11, Xizhimen South Street, Beijing, 100044 China
| | - Wei Zhu
- grid.416243.60000 0000 9738 7977Mudanjiang Medical University, No.3 Tong Xiang Street, Mudanjiang City, 157011 China
| | - Weiting Zhang
- grid.416243.60000 0000 9738 7977Mudanjiang Medical University, No.3 Tong Xiang Street, Mudanjiang City, 157011 China
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Gupta A, LaFaver K, Duque KR, Lingaiah A, Meriwether KV, Gaskins J, Gomes J, Espay AJ, Mahajan A. Pelvic Floor Health in Women with Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2021; 11:857-864. [PMID: 33579875 DOI: 10.3233/jpd-202491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Urinary dysfunction and constipation, manifestations of pelvic floor dysfunction are common sources of disability and impaired quality of life in women with Parkinson's disease (PD). OBJECTIVE We sought to evaluate the pelvic floor health amongst women with PD and their reporting of bladder and bowel symptoms. METHODS We surveyed women with PD and age-matched controls about pelvic floor health using validated questionnaires. All participants completed the Pelvic Floor Disability Index (PFDI-20), the Pelvic Floor Impact Questionnaire (PFIQ-7) and the Patient-Reported Outcomes Measurement Information System (PROMIS) short form version 2.0 Cognitive Function 8a. Additionally, PD patients underwent the Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) scale and the Montreal Cognition Assessment (MoCA). RESULTS Women with PD (n = 59; age, 70.4±8.6 years, PROMIS cognitive score, 52.0±7.8) self-reported urinary symptoms to a greater extent than controls (n = 59; age, 70.2±8.7 years, PROMIS cognitive score, 51.0±10) (68% vs 43%, p < 0.01). The difference was mirrored by higher (worse) scores on both PFDI-20 (35.4 vs 15.6; p = 0.01) and PFIQ-7 (4.8 vs 0; p < 0.01) for PD women compared to controls. Only 63% of all participants with self-reported pelvic floor symptoms had previously reported these symptoms to a health care provider. There was no difference in utilization of specialty care between the two groups (30% vs 46%, p = 0.2). CONCLUSION Pelvic floor dysfunction, more common amongst women with PD, is underreported and undertreated. Our study identifies a key gap in care of women with PD.
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Affiliation(s)
- Ankita Gupta
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics & Gynecology, University of Louisville School of Medicine, Louisville, KY, USA
| | - Kathrin LaFaver
- Division of Movement disorders, Department of Neurology, University of Louisville School of Medicine, Louisville, KY, USA
| | - Kevin R Duque
- James J. and Joan A. Gardner Center for Parkinson's Disease and Movement Disorders, University of Cincinnati, Cincinnati, OH, USA
| | - Anushree Lingaiah
- Division of Movement disorders, Department of Neurology, University of Louisville School of Medicine, Louisville, KY, USA
| | - Kate V Meriwether
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics & Gynecology, University of Louisville School of Medicine, Louisville, KY, USA
| | - Jeremy Gaskins
- Department of Bioinformatics & Biostatistics, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA
| | - Josephine Gomes
- Department of Family and Geriatric Medicine, University of Louisville, Louisville, KY, USA
| | - Alberto J Espay
- James J. and Joan A. Gardner Center for Parkinson's Disease and Movement Disorders, University of Cincinnati, Cincinnati, OH, USA
| | - Abhimanyu Mahajan
- James J. and Joan A. Gardner Center for Parkinson's Disease and Movement Disorders, University of Cincinnati, Cincinnati, OH, USA
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Do women runners report more pelvic floor symptoms than women in CrossFit®? A cross-sectional survey. Int Urogynecol J 2020; 32:295-302. [PMID: 32955598 DOI: 10.1007/s00192-020-04531-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Women who perform high-impact activities might be at greater risk of pelvic floor dysfunction (PFD) than those participating in low-impact exercise; however, little is known about whether PFD is more common in one type of high-impact activity than another. The aim of this study was to compare the prevalence of PFD symptoms in women who engage in high-impact activity compared with CrossFit®-brand training (CF). METHODS An online survey collected data from 1,379 women (521 runners, 858 CF) on exercise participation, parity, and PFD symptoms, via the Pelvic Floor Distress Inventory (PFDI-20). Specific questions from each PFDI-20 subscale further investigated symptoms of pelvic organ prolapse (POP), anal incontinence (AI), as well as stress (SUI) and urgency (UUI) urinary incontinence. RESULTS Symptoms of POP and AI were significantly higher in runners (POP 12.7%, AI 34.0%) than in CF (POP 7.8%, p = 0.003; AI 27.7%, p = 0.014). There was no significant difference in SUI symptoms between groups (37.0% vs 41.0% respectively, p = 0.141). Vaginally parous runners reported significantly more symptoms of POP (19.0% vs 12.2%, p = 0.023), AI (39.3% vs 27.2%, p = 0.001), and UUI (36.3% vs 29.0%, p = 0.037) than CF. CONCLUSION Women, particularly parous women, who participate in running, have a higher prevalence of POP and AI symptoms than women who participate in CF. This suggests that CrossFit®-brand training might not be more detrimental to PFD symptoms than other high-impact activity, such as running. This study does not conclude a pelvic floor health benefit of one exercise over another, but highlights that exercise options can be provided to women.
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Zuchelo LTS, Santos EFDS, Dos Santos Figueiredo FW, Adami F, Bezerra IMP, Raimundo RD, Sorpreso ICE, de Abreu LC. Pelvic floor disorders in postpartum adolescents in the Western Amazon: a cross-sectional study. Int J Womens Health 2018; 10:477-486. [PMID: 30197542 PMCID: PMC6113915 DOI: 10.2147/ijwh.s169504] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
PURPOSE To analyze the postpartum pelvic floor disorders (PFD) and mode of delivery among adolescents, late adolescents, and young women from Western Amazon. PATIENTS AND METHODS Cross-sectional study was carried out in the urban area of Western Amazon in the city of Rio Branco, Acre, Brazil, from October 2016 to February 2017. This is a convenience sample of women up to 30 years who completed six months postpartum, separated in three groups according to maternal age: adolescents (age ≤19 years), late adolescents (20-24 years), and young women (25-30 years). Participants were home interviewed and answered Pelvic Floor Distress Inventory-20 (PFDI-20). Delivery clinical data were collected from patient's medical records. RESULTS In total, 285 participants were interviewed: 41 adolescents, 103 late adolescents, and 141 young women. After controlling for confounding factors, prevalences of PFD were higher in the adolescents' group compared with the young women's group (urinary incontinence [UI], prevalence ratio [PR] = 1.75, 95% CI 1.14-2.69; urge urinary incontinence [UUI], PR = 1.88, 95% CI 1.02-3.47; stress urinary incontinence, PR = 2.00, 95% CI 1.11-3.62; fecal incontinence [FI], PR = 4.40, 95% CI 1.36-14.27). PFDI-20 scores also presented higher values in the adolescent group (Pelvic Organ Prolapse Distress Inventory [POPDI], PR = 2.02, 95% CI 1.49-2.75; urinary distress inventory [UDI], PR = 2.09, 95% CI 1.47-2.98; PFDI, PR = 2.12, 95% CI 1.47-2.98). Analyzing the influence of cesarean section, adolescents have higher prevalence of UI (PR = 1.84, 95% CI 1.04-3.26, P=0.037), UUI (PR = 2.36, 95% CI 1.03-5.40, P=0.042), and FI (PR = 4.09, 95% CI 1.21-13.81, P=0.023). In addition, POPDI (PR = 2.15, 95% CI 1.60-2.89, P<0.001), UDI (PR = 2.25, 95% CI 1.61-3.16, P<0.001), and PFDI (PR = 2.27, 95% CI 1.68-3.08, P<0.001) scores are also higher among adolescents where the baby is born by cesarean section. CONCLUSION Adolescents present higher prevalence and symptoms of PFD; furthermore, cesarean delivery has a greater negative influence on the pelvic floor of adolescents when compared with young women. This reinforces the importance of PFD investigation among the adolescent population, mainly in developing countries which have high rates of adolescent pregnancy and cesarean section.
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Affiliation(s)
- Lea Tami Suzuki Zuchelo
- Study Design and Scientific Writing Laboratory, ABC Medical School (FMABC), Santo André, SP, Brazil,
- School of Physiotherapy, Universida Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil
| | - Edige Felipe de Sousa Santos
- Study Design and Scientific Writing Laboratory, ABC Medical School (FMABC), Santo André, SP, Brazil,
- Department of Epidemiology, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Francisco Winter Dos Santos Figueiredo
- Study Design and Scientific Writing Laboratory, ABC Medical School (FMABC), Santo André, SP, Brazil,
- Epidemiology and Data Analysis Laboratory, ABC Medical School (FMABC), Santo André, SP, Brazil
| | - Fernando Adami
- Epidemiology and Data Analysis Laboratory, ABC Medical School (FMABC), Santo André, SP, Brazil
| | - Italla Maria Pinheiro Bezerra
- Study Design and Scientific Writing Laboratory, ABC Medical School (FMABC), Santo André, SP, Brazil,
- Nursing Department, School of Sciences of Santa Casa de Misericórdia de Vitoria (EMESCAM), Vitória, ES, Brazil
| | | | - Isabel Cristina Esposito Sorpreso
- Study Design and Scientific Writing Laboratory, ABC Medical School (FMABC), Santo André, SP, Brazil,
- Gynecology Discipline, Obstetrics and Gynecology Department, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil,
| | - Luiz Carlos de Abreu
- Study Design and Scientific Writing Laboratory, ABC Medical School (FMABC), Santo André, SP, Brazil,
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Carrillo-Izquierdo MD, Slim M, Hidalgo-Tallon J, Calandre EP. Pelvic floor dysfunction in women with fibromyalgia and control subjects: Prevalence and impact on overall symptomatology and psychosocial function. Neurourol Urodyn 2018; 37:2702-2709. [PMID: 29974511 DOI: 10.1002/nau.23723] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 05/11/2018] [Indexed: 12/28/2022]
Abstract
AIMS To evaluate the prevalence, distress, and impact of pelvic floor dysfunction (PFD) symptomatology in women with fibromyalgia and control women. We also aimed to evaluate the impact of PFD symptomatology on several psychosocial measures such as mood, sleep, pain, and quality of life. METHODS We conducted a cross-sectional study in women with fibromyalgia and control women from the general population. Using a structured survey, we collected sociodemographic and clinical data, assessed the prevalence of PFD and evaluated the distress (PFDI-20) and the impact (PFIQ-7) caused by its symptomatology. Using Spanish-validated questionnaires, we also evaluated mood and sleep disturbances, bodily pain, and quality of life in subjects with and without PFD. In participants with fibromyalgia, we assessed the severity and impact of the disease using the Fibromyalgia Impact Questionnaire (FIQR). RESULTS Two hundred and twenty-six patients with fibromyalgia and 222 control women completed the surveys. Two hundred and twenty patients (93%) and 140 controls (63%) reported PFD-related symptoms. Both the scores of distress (143.1 ± 5.7 vs 96.1 ± 4.8, P < 0.0001) and impact (122.4 ± 5.6 vs 100.6 ± 6.4, P < 0.0001) caused by PFD symptoms were significantly higher in women with fibromyalgia than in controls. There was a significant positive relationship between fibromyalgia severity and both PFDI-20 (r2 = 0.32, P < 0.0001) and PFIQ-7 scores (r2 = 0.375, P < 0.0001). Depression severity, sleep disturbances, bodily pain, and low quality of life were highest in women with fibromyalgia and PFD and lowest in control women without PFD. CONCLUSIONS PFD-related symptoms were significantly more frequent in women with fibromyalgia than in controls. PFD symptomatology, when present, negatively influenced mood, sleep quality, and quality of life of both patients with fibromyalgia and controls.
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Affiliation(s)
| | - Mahmoud Slim
- Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Javier Hidalgo-Tallon
- Cátedra de Ozonoterapia y Dolor, Universidad Católica "San Antonio" de Murcia, Murcia, Andalucía, Spain
| | - Elena P Calandre
- Instituto de Neurociencias, Universidad de Granada, Armilla, Granada, Spain
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Long-term outcome after transvaginal mesh repair of pelvic organ prolapse. Int Urogynecol J 2016; 27:1069-74. [PMID: 26837782 DOI: 10.1007/s00192-015-2939-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 12/18/2015] [Indexed: 12/17/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The aim of this study was to report long-term subjective and objective outcomes after the transvaginal mesh (TVM) procedure in long-term. Possible late-onset complications were of particular interest. METHODS This was a retrospective analysis of TVM performed using Prolift™ transvaginal mesh measuring subjective outcome using validated questionnaires. Objective outcome was assessed using the Pelvic Organ Prolapse Quantification (POP-Q) system using two definitions: POP-Q stage ≤ 1, and vaginal wall prolapse at or above the hymen or vaginal apex not descending below the upper third of the vagina. Complications were reported with the Prosthesis/Graft Complication Classification Code designed by the International Continence Society/International Urogynecological Association (ICS/IUGA). RESULTS Of 195 patients, 161 (82.6 %) participated this study after a median of 7 years. The scores in questionnaires evaluating urinary (UI) or anal incontinence and constipation or pelvic floor symptoms were low, indicating favorable surgical outcomes. Altogether, 80.1 % of patients were satisfied with the procedure. Anatomical cure was 56.4 % and 69.3 % depending on the definition used. Reoperation due to POP in any compartment was performed in 16.2 % of patients. Mesh exposure rate was 23 %, most of these being asymptomatic and of late onset. CONCLUSIONS Outcome of the TVM procedure was satisfactory. Anatomical cure was inferior to subjective cure. Mesh exposure rate was high; most exposures observed in the long-term were of late onset and were asymptomatic.
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Impact of pelvic floor muscle training in the postpartum period. Int Urogynecol J 2015; 27:255-60. [DOI: 10.1007/s00192-015-2822-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 08/02/2015] [Indexed: 01/08/2023]
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Jones KD, Maxwell C, Mist SD, King V, Denman MA, Gregory WT. Pelvic Floor and Urinary Distress in Women with Fibromyalgia. Pain Manag Nurs 2015; 16:834-40. [PMID: 26259883 DOI: 10.1016/j.pmn.2015.06.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 05/27/2015] [Accepted: 06/04/2015] [Indexed: 02/08/2023]
Abstract
Fibromyalgia (FM) patients were recently found to have more symptom burden from bothersome pelvic pain syndromes that women seeking care for pelvic floor disease at a urogynecology clinic. We sought to further characterize pelvic floor symptoms in a larger sample of FM patients using of validated questionnaires. Female listserv members of the Fibromyalgia Information Foundation completed an online survey of three validated questionnaires: the Pelvic Floor Distress Inventory 20 (PFDI-20), the Pelvic Pain, Urgency and Frequency Questionnaire (PUF), and the Revised Fibromyalgia Impact Questionnaire (FIQR). Scores were characterized using descriptive statistics. Patients (n = 204 with complete data on 177) were on average 52.3 ± 11.4 years with a mean parity of 2.5 ± 1.9. FM severity based on FIQR score (57.2 ± 14.9) positively correlated with PFDI-20 total 159.08 ± 55.2 (r = .34, p < .001) and PUF total 16.54 ± 7 (r = .36, p < .001). Women with FM report significantly bothersome pelvic floor and urinary symptoms. Fibromyalgia management should include evaluation and treatment of pelvic floor disorders recognizing that pelvic distress and urinary symptoms are associated with more severe FM symptoms. Validated questionnaires, like the ones used in this study, are easily incorporated into clinical practice.
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Affiliation(s)
- Kim Dupree Jones
- School of Nursing, Oregon Health & Science University, Portland, Oregon.
| | - Charlene Maxwell
- School of Nursing, Oregon Health & Science University, Portland, Oregon
| | - Scott D Mist
- School of Nursing, Oregon Health & Science University, Portland, Oregon
| | - Virginia King
- Aethena Gynecology Associates, Vancouver, Washington
| | - Mary Anna Denman
- Department of Urogynecology, Oregon Health & Science University, Portland, Oregon
| | - W Thomas Gregory
- Department of Urogynecology, Oregon Health & Science University, Portland, Oregon
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Gafni-Kane A, Zhou Y, Botros SM. Predictive modeling and threshold scores for care seeking among women with urinary incontinence: The short forms of the Pelvic Floor Distress Inventory and Urogenital Distress Inventory. Neurourol Urodyn 2015. [PMID: 26207922 DOI: 10.1002/nau.22833] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AIMS To further the interpretability of the Pelvic Floor Distress Inventory (PFDI-20) and Urogenital Distress Inventory (UDI-6) by (i) evaluating the ability of these measures to distinguish between women with urinary incontinence who do and do not seek care, (ii) defining PFDI-20 and UDI-6 threshold scores above which women with urinary incontinence seek care, and (iii) developing a predictive model for incontinence care seeking. METHODS An observational study was conducted with two groups of women with urinary incontinence: 256 who had not sought care and 90 seeking initial care at a tertiary center. Sample sizes were based upon the prevalence of care seeking for urinary incontinence and the number of potential predictors for care seeking. Wilcoxon rank-sum tests, receiver operating characteristics, and multivariable logistic regression were use to achieve the study aims. RESULTS Women with urinary incontinence who sought care had higher median PFDI-20 and UDI-6 scores compared to non-care seekers (73.96 vs. 16.67, P < 0.0001, and 41.67 vs. 8.33, P < 0.0001). A PFDI-20 score of 33.33 (83.33% sensitivity and 79.30% specificity) had very good discriminatory accuracy in distinguishing care and non-care seekers (AUC 0.886 ± 0.019 [95%CI 0.8518, 0.9254] P < 0.0001). A UDI-6 score of 25.00 (83.33% sensitivity and 83.59% specificity) had excellent discriminatory accuracy in distinguishing care and non-care seekers (AUC 0.9025 ± 0.0190 [95%CI 0.8653, 0.9398] P < 0.0001). A multivariable predictive model accurately identified 82.4% of care and non-care seekers. CONCLUSIONS A PFDI-20 score of 33.33 and UDI-6 score of 25.00 provide meaningful benchmarks for care seeking among women with urinary incontinence. Neurourol. Urodynam. 35:949-954, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Adam Gafni-Kane
- Female Pelvic Medicine and Reconstructive Surgery, NorthShore University HealthSystem, University of Chicago Pritzker School of Medicine, Chicago, Illinois.
| | - Ying Zhou
- Center for Biomedical Research Informatics, NorthShore University HealthSystem, Chicago, Illinois
| | - Sylvia M Botros
- Female Pelvic Medicine and Reconstructive Surgery, NorthShore University HealthSystem, University of Chicago Pritzker School of Medicine, Chicago, Illinois
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