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Assefa Demissie B, Tennfjord MK, Mihiret T, Abich Y, Zemed A, Mengistu Z, Nigatu SG. Prevalence and associated factors of symptomatic pelvic floor disorders among women living in Debre Tabor Town, Northwest Amhara, Ethiopia. BMC Womens Health 2024; 24:367. [PMID: 38915020 PMCID: PMC11194954 DOI: 10.1186/s12905-024-03176-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 05/30/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Pelvic floor disorders are a group of disorders affecting the pelvic floor that include clinically definable conditions such as pelvic organ prolapse, urinary incontinence and fecal incontinence. These conditions silently affect millions of women worldwide and related problems are not well disclosed by women due to associated social stigma or lack of access to services in developing countries. Thus, the magnitude and related burden of these conditions vary, and little is known about them. This study was conducted to assess the magnitude and associated factors of symptomatic pelvic floor disorders in Debre Tabor town, Northwest, Ethiopia, from May 30-July 30, 2020. METHOD A community-based cross-sectional study was conducted on child bearing women (> 15 years) who resided in Debre Tabor Town from May 30-July 30, 2020. The participants were selected through multistage systematic random sampling. The data were collected via a structured questionnaire through face-to-face interviews, entered into Epi-info-7.2, and subsequently analyzed using SPSS version 20. The prevalence of pelvic floor disorders was presented along with the 95% CI. RESULTS A total of 402 women participated in this study, 59 (14.7%; 95% CI; 11.4, 18.2) of whom reported one or more types of pelvic floor disorders. The most prevalently reported pelvic floor disorders were pelvic organ prolapse (13.9%; 95% CI: 10.9, 17.4), urinary incontinence (10.9%; 95% CI: 7.4, 9.2) and fecal incontinence (7.7%; 95% CI: 5.2, 10.2). Additionally, aging, multiparity and having early marriage (< 18 yrs.) were identified as potential risk factors associated with pelvic floor disorders. CONCLUSIONS The prevalence of symptomatic pelvic floor disorders in the current study was high. Thus, early detection, preventive and treatment strategies should be considered. In addition, it is better to educate the community and women on the association of early marriage and multiparty with PFDs.
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Affiliation(s)
- Berihun Assefa Demissie
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Merete Kolberg Tennfjord
- School of Health Sciences, Department of Health and Exercise, Kristiania University, Oslo, Norway
| | - Tewodros Mihiret
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yohannes Abich
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ashenafi Zemed
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zelalem Mengistu
- Department of Gynecology and Obstetrics, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Solomon Gedlu Nigatu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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Dayican DK, Hosbay Z, Ozyurek B, Utku Umut G. Pelvic floor symptoms and symptom-related quality of life in the mothers of children with cerebral palsy: a pilot cross-sectional study. Women Health 2024; 64:404-415. [PMID: 38706221 DOI: 10.1080/03630242.2024.2349559] [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: 07/21/2023] [Accepted: 04/24/2024] [Indexed: 05/07/2024]
Abstract
Pelvic floor symptoms may occur in women with low back pain due to dysfunction of the spinal stabilization muscles. Low back pain is the most common musculoskeletal problem experienced by the mothers of children with cerebral palsy (CP). Therefore, our aim in this study was to examine pelvic floor symptoms and symptom-related quality of life in the mothers of children with CP. The study included 48 mothers of children with CP (n = 23) or without neurodevelopmental problems (n = 25). The mothers' pelvic floor symptoms and symptom-related quality of life were evaluated with the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7). PFDI-20 and PFIQ-7 scores did not differ between the two groups of mothers (p > .05). Additionally, moderately significant positive correlations were found between the age of the child with CP and duration of carrying and the PFDI-20 (r = 0.419, p = .047) and PFIQ-7 (r = 0.427, p = .042) scores. Pelvic floor symptoms and symptom-related quality of life in the mothers of children with CP were similar to those in the mothers of children without neurodevelopmental problems. As the age of the child with CP and duration of carrying increase, the urinary symptoms and urinary and colorectoanal symptoms-related quality of life in their mothers may worsen.
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Affiliation(s)
- Damla Korkmaz Dayican
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, İzmir Tınaztepe University, İzmir, Turkey
- Department of Physiotherapy and Rehabilitation, Graduate Education Institute, Biruni University, İstanbul, Turkey
| | - Zeynep Hosbay
- Department of Physiotherapy and Rehabilitation, Graduate Education Institute, Biruni University, İstanbul, Turkey
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Biruni University, Istanbul, Turkey
| | - Burcin Ozyurek
- Department of Physiotherapy and Rehabilitation, Graduate Education Institute, Biruni University, İstanbul, Turkey
- Pelvic Floor Center, Yeditepe University Hospital, İstanbul, Turkey
| | - Gulsena Utku Umut
- Department of Physiotherapy and Rehabilitation, Graduate Education Institute, Biruni University, İstanbul, Turkey
- Department of Physiotherapy and Rehabilitation (English), Faculty of Health Sciences, Haliç University, İstanbul, Turkey
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Morciano A, Schiavi MC, Frigerio M, Licchetta G, Tinelli A, Cervigni M, Marzo G, Scambia G. Quality of Life and Sexual Function after Laparoscopic Posterior Vaginal Plication Plus Sacral Colpopexy for Severe Posterior Vaginal Prolapse. J Clin Med 2024; 13:616. [PMID: 38276122 PMCID: PMC10816297 DOI: 10.3390/jcm13020616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/19/2023] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Laparoscopic sacral colpopexy (LSC) is the gold standard treatment for women with apical/anterior pelvic organ prolapse (POP). For isolated posterior vaginal prolapse, instead, the literature suggests fascial native tissue repair. This is a retrospective 2-year quality-of-life follow-up study after laparoscopic posterior plication (LPP) combined with LSC in patients with anterior/apical prolapse combined with severe posterior colpocele. The primary endpoint was to evaluate the subjective outcomes quality of life (QoL), sexual function, and patient satisfaction rate. The secondary endpoint was to evaluate perioperative and anatomical outcomes at the 2-year follow-up. METHODS A total of 139 consecutive patients with anterior and/or apical prolapse (POP-Q stage ≥ II) and severe posterior vaginal prolapse (posterior POP-Q stage ≥ III) were retrospectively selected from our database among women who underwent, from November 2018 to February 2021, a "two-meshes" LSC. The patients were classified into Group A (81 patients; LSC plus LPP) and Group B (67 patients; LSC alone). The primary endpoint was evaluated using the Patient Global Impression of Improvement (PGI-I), the Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6), the Pelvic Floor Impact Questionnaire-7 (PFIQ-7), the Female Sexual Distress Scale (FSDS), the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), and the EuroQol (EQ-5D). The secondary endpoint was studied using the POP-Q study and an intra-, peri-, and post-operative complications assessment. Two-year follow-up data were analyzed for the study. RESULTS At 2 years, all women showed a statistically significant amelioration of their symptoms on the QoL questionnaires. We found a statistical difference in favor of posterior plication in terms of the PGI-I successful outcome rate (Group A versus B: 85.3% versus 67.1%), FSDS (median 11 versus 21), and PISQ-12 (median 89 versus 62) (p < 0.05 for all comparisons). A significant improvement of all EQ-5D values was observed from baseline to 2-year follow-up, and only for the "pain/discomfort" domains did we observe a significant improvement in LSC plus LPP patients versus LSC alone (p < 0.05). LSC plus LPP women showed, at 2 years, a significant amelioration of their Ap and GH POP-Q points. We observed no statistical differences in terms of intra-post-operative complications or anatomic failure rate between groups. CONCLUSIONS Our LPP approach to LSC appears to be a safe, feasible, and effective treatment for advanced pelvic organ prolapse with a significant impact on the patient's general health and sexual quality of life. Adding laparoscopic posterior vaginal plication to "two-meshes" sacral colpopexy is recommended in patients with apical/anterior prolapse and concomitant severe posterior colpocele. This surgical approach, in addition to improving the anatomical results of these patients, is associated with a significant improvement in sexual and quality of life indexes.
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Affiliation(s)
- Andrea Morciano
- Panico Pelvic Floor Center, Department of Gynaecology and Obstetrics, Pia Fondazione “Card. G. Panico”, 73039 Tricase, Italy; (G.L.); (G.M.)
- AIUG Research Group, Associazione Italiana di UroGinecologia e del Pavimento Pelvico, 00168 Roma, Italy; (M.C.S.); (M.F.); (M.C.)
| | - Michele Carlo Schiavi
- AIUG Research Group, Associazione Italiana di UroGinecologia e del Pavimento Pelvico, 00168 Roma, Italy; (M.C.S.); (M.F.); (M.C.)
- Department of Gynaecology and Obstetrics, “Sandro Pertini” Hospital, 00157 Roma, Italy
| | - Matteo Frigerio
- AIUG Research Group, Associazione Italiana di UroGinecologia e del Pavimento Pelvico, 00168 Roma, Italy; (M.C.S.); (M.F.); (M.C.)
- Department of Obstetrics and Gynecology, ASST Monza, San Gerardo Hospital, 20900 Monza, Italy
| | - Giulio Licchetta
- Panico Pelvic Floor Center, Department of Gynaecology and Obstetrics, Pia Fondazione “Card. G. Panico”, 73039 Tricase, Italy; (G.L.); (G.M.)
- AIUG Research Group, Associazione Italiana di UroGinecologia e del Pavimento Pelvico, 00168 Roma, Italy; (M.C.S.); (M.F.); (M.C.)
| | - Andrea Tinelli
- Department of Gynaecology and Obstetrics, “Veris Delli Ponti Hospital”, 73020 Scorrano, Italy;
| | - Mauro Cervigni
- AIUG Research Group, Associazione Italiana di UroGinecologia e del Pavimento Pelvico, 00168 Roma, Italy; (M.C.S.); (M.F.); (M.C.)
- Department of Urology, Università “La Sapienza”, ICOT-Latina, 00161 Roma, Italy
| | - Giuseppe Marzo
- Panico Pelvic Floor Center, Department of Gynaecology and Obstetrics, Pia Fondazione “Card. G. Panico”, 73039 Tricase, Italy; (G.L.); (G.M.)
| | - Giovanni Scambia
- Department of Gynaecology and Obstetrics, Fondazione Policlinico Universitario “A. Gemelli”, Università Cattolica del Sacro Cuore, 00168 Roma, Italy;
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Peinado Molina RA, Hernández Martínez A, Martínez Vázquez S, Martínez Galiano JM. Influence of pelvic floor disorders on quality of life in women. Front Public Health 2023; 11:1180907. [PMID: 37942254 PMCID: PMC10629477 DOI: 10.3389/fpubh.2023.1180907] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/25/2023] [Indexed: 11/10/2023] Open
Abstract
Objective To determine whether the different pelvic floor disorders are associated with changes in perceived quality of life (QoL), globally and in its sub-dimensions. Methods An observational study was conducted with women in Spain between 2021 and 2022. Information was collected using a self-developed questionnaire on sociodemographic data, employment, history and health status, lifestyle and habits, obstetric history, and health problems. The SF-12 questionnaire was used to assess quality of life. The Pelvic Floor Distress Inventory (PFDI-20) was used to assess the presence and impact of pelvic floor problems, and includes the POPDI-6 subscales for prolapse, CRADI- 8 for colorectal symptoms, and UDI-6 for urinary symptoms. Crude (MD) and adjusted mean differences (aMD) were estimated with their respective 95% confidence intervals (CI). Results Thousand four hundred and forty six women participated in the study with a mean age of 44.27 (SD = 14.68). A statistical association was observed between all the pelvic floor disorders and QoL, overall and in all its dimensions (p <0.001), in the bivariable analysis. The lowest scores were observed in the emotional component. After adjusting for confounding factors, the pelvic floor disorders in general (aMD -0.21, 95% CI: -0.23 to -0.20), the impact of uterine prolapse symptoms (aMD -0.20, 95% CI: -0.27 to -0.12), the colorectal-anal symptoms (aMD -0.15, 95% CI: -0.22 to -0.09), and urinary symptoms (aMD -0.07, 95% CI: -0.13 to -0.03) was negatively associated on the score on the SF-12 questionnaire (p <0.05). Conclusions Women who have a pelvic floor dysfunction, symptoms of pelvic organ prolapse, colorectal-anal symptoms, or urinary symptoms, have a worse perceived quality of life in all dimensions. Prolapse symptoms have the biggest impact, and the emotional component of QoL is the most affected sub-domains.
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Affiliation(s)
| | - Antonio Hernández Martínez
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Nursing, University of Castilla la Mancha, Ciudad Real, Spain
| | | | - Juan Miguel Martínez Galiano
- Department of Nursing, University of Jaén, Jaén, Spain
- Epidemiology and Public Health CIBER (CIBERESP), Madrid, Spain
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Peinado-Molina RA, Hernández-Martínez A, Martínez-Vázquez S, Rodríguez-Almagro J, Martínez-Galiano JM. Pelvic floor dysfunction: prevalence and associated factors. BMC Public Health 2023; 23:2005. [PMID: 37838661 PMCID: PMC10576367 DOI: 10.1186/s12889-023-16901-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 10/04/2023] [Indexed: 10/16/2023] Open
Abstract
BACKGROUND Pelvic floor dysfunction in women encompasses a wide range of clinical disorders: urinary incontinence, pelvic organ prolapse, fecal incontinence, and pelvic-perineal region pain syndrome. A literature review did not identify any articles addressing the prevalence of all pelvic floor dysfunctions. OBJECTIVE Determine the prevalence of the group of pelvic floor disorders and the factors associated with the development of these disorders in women. MATERIAL AND METHODS This observational study was conducted with women during 2021 and 2022 in Spain. Sociodemographic and employment data, previous medical history and health status, lifestyle and habits, obstetric history, and health problems were collected through a self-developed questionnaire. The Pelvic Floor Distress Inventory (PFDI-20) was used to assess the presence and impact of pelvic floor disorders. Pearson's Chi-Square, Odds Ratio (OR) and adjusted Odds Ratio (aOR) with their respective 95% confidence intervals (CI) were calculated. RESULTS One thousand four hundred forty-six women participated. Urinary incontinence occurred in 55.8% (807) of the women, fecal incontinence in 10.4% (150), symptomatic uterine prolapse in 14.0% (203), and 18.7% (271) reported pain in the pelvic area. The following were identified as factors that increase the probability of urinary incontinence: menopausal status. For fecal incontinence: having had instrumental births. Factors for pelvic organ prolapse: number of vaginal births, one, two or more. Factors for pelvic pain: the existence of fetal macrosomia. CONCLUSIONS The prevalence of pelvic floor dysfunction in women is high. Various sociodemographic factors such as age, having a gastrointestinal disease, having had vaginal births, and instrumental vaginal births are associated with a greater probability of having pelvic floor dysfunction. Health personnel must take these factors into account to prevent the appearance of these dysfunctions.
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Affiliation(s)
| | - Antonio Hernández-Martínez
- Department of Nursing, Physiotherapy and Occupational Therapy, Ciudad Real, Faculty of Nursing, University of Castilla-La Mancha, Ciudad Real, Spain
| | | | - Julián Rodríguez-Almagro
- Department of Nursing, Physiotherapy and Occupational Therapy, Ciudad Real, Faculty of Nursing, University of Castilla-La Mancha, Ciudad Real, Spain
| | - Juan Miguel Martínez-Galiano
- Department of Nursing, University of Jaen, Jaen, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Barba M, Cola A, Melocchi T, Braga A, Castronovo F, Manodoro S, Pennacchio M, Munno GM, Ruffolo AF, Degliuomini RS, Salvatore S, Torella M, Frigerio M. Italian validation of the Pelvic Floor Distress Inventory (PFDI-20) questionnaire. Int Urogynecol J 2023; 34:2459-2465. [PMID: 37195425 DOI: 10.1007/s00192-023-05572-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 04/27/2023] [Indexed: 05/18/2023]
Abstract
INTRODUCTION AND HYPOTHESIS The use of validated Quality of Life (QoL) questionnaires is useful in the standardization and interpretation process of pelvic floor patient symptoms, due to their functional nature and high prevalence. The Pelvic Floor Distress Inventory QoL questionnaire (PFDI-20) serves both as a symptom inventory and a measure of the degree of bother and distress caused by pelvic floor symptoms. It includes items related to pelvic organ prolapse and lower gastrointestinal and bladder dysfunction. METHODS After consensus translation and a comprehension test, the Italian version of the questionnaire was submitted to patients reporting bowel, bladder, or pelvic disorders (cases) and to asymptomatic women (controls). Cases received the questionnaire once again 2 weeks later by email. RESULTS A total of 254 patients answered the questionnaire. Construct validity was demonstrated by discriminating between cases and controls. Convergent validity was demonstrated for each domain (F < 0.001). In-ernal consistency reliability showed a satisfactory range (0.816-0.860). CONCLUSIONS The PFDI-20 allows a comprehensive assessment of the effect of pelvic floor disorders on the quality of life of women. Moreover, the PFDI-20 represents a very solid QoL tool, since it has been extensively used in literature, and its use is highly recommended by the International Consultation on Incontinence. The present study demonstrated good features for the Italian version of the PFDI-20 questionnaire.
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Affiliation(s)
| | - Alice Cola
- Gynecology Unit, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | | | - Andrea Braga
- EOC Beata Vergine, Mendrisio, Switzerland
- Italian Urogynecology - Pelvic Floor Work Group (GLUP), Monza, Italy
| | | | - Stefano Manodoro
- Italian Urogynecology - Pelvic Floor Work Group (GLUP), Monza, Italy.
- ASST Santi Paolo E Carlo, San Paolo University Hospital, University of Milano, Via Antonio Di Rudinì 8, 20142, Milan, Italy.
| | - Marika Pennacchio
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gaetano Maria Munno
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandro Ferdinando Ruffolo
- Vita-Salute San Raffaele University, Milan, Italy
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Rebecca Susanna Degliuomini
- Vita-Salute San Raffaele University, Milan, Italy
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Stefano Salvatore
- Vita-Salute San Raffaele University, Milan, Italy
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marco Torella
- Italian Urogynecology - Pelvic Floor Work Group (GLUP), Monza, Italy
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Matteo Frigerio
- Gynecology Unit, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
- Italian Urogynecology - Pelvic Floor Work Group (GLUP), Monza, Italy
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Arruda GTD, Paines GP, Silva BRD, Pairé LX, Pivetta HMF, Braz MM, Virtuoso JF. Relationship Involving Sexual Function, Distress Symptoms of Pelvic Floor Dysfunction, and Female Genital Self-Image. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2023; 45:e542-e548. [PMID: 37846187 PMCID: PMC10579922 DOI: 10.1055/s-0043-1772474] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 06/12/2023] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVE To assess the relationship involving sexual function (SF), the distress symptoms caused by pelvic floor dysfunction (PFD), and female genital self-image (GSI). MATERIALS AND METHODS We assessed the GSI, SF and PFD distress symptoms by the Female Genital Self-Image Scale (FGSIS), the Female Sexual Function Index (FSFI), and the Pelvic Floor Distress Inventory (PFDI-20) respectively. Data were analyzed by multiple linear regression. RESULTS Among the 216 women (age: 50.92 ± 16.31 years) who participated in the study, 114 were sexually active in the previous 4 weeks. In the total sample (p < 0.001; adjusted R2 = 0.097) and among sexually active women (p = 0.010; adjusted R2 = 0.162), the distress symptoms caused by pelvic organ prolapse (POP) were related to the GSI. Among sexually active women, sexual desire also was related to the GSI (p < 0.001; adjusted R2 = 0.126). CONCLUSION The findings of the present study provide additional knowledge about female GSI and suggest that SF and POP distress symptoms should be investigated together with the GSI in the clinical practice.
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Affiliation(s)
| | - Gabrielle Peres Paines
- Departamento de Fisioterapia e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Bianca Rangel da Silva
- Departamento de Fisioterapia e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Lauren Xavier Pairé
- Departamento de Fisioterapia e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | | | - Melissa Medeiros Braz
- Departamento de Fisioterapia e Reabilitação, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
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Mikeltadze I, Täär K, Kadastik Ü, Soplepmann P, Rull K. Validation of the short forms of the Pelvic Floor Distress Inventory and the Pelvic Floor Impact Questionnaire in Estonian. Int Urogynecol J 2023; 34:2235-2240. [PMID: 37067571 PMCID: PMC10506922 DOI: 10.1007/s00192-023-05532-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 03/16/2023] [Indexed: 04/18/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Pelvic Floor Distress Inventory (PFDI-20) and the Pelvic Floor Impact Questionnaire (PFIQ-7) are reliable instruments for evaluating the quality of life in women with pelvic organ prolapse (POP). They have been translated and validated in many languages. The study was aimed at validating the Estonian translations of the PFDI-20 and PFIQ-7 tools. METHODS The questionnaires were translated into Estonian using a multistep translation method. A total of 132 women were enrolled: patients with diagnosed POP (n=57) were allocated to test-retest reliability analyses, and those with no POP signs (n=88) completed the questionnaire only once. The total scores of questionnaires and their subscales of both patient and reference groups were compared. Item response rate, floor and ceiling effects, corrected item-total correlations, internal consistency, and convergent and discriminant validity were analyzed. The study was approved by the Ethics Committee of Human Research of the University Clinic of Tartu, Estonia, and informed consent was obtained from each participant. RESULTS The translated questionnaires demonstrated good internal consistency (Cronbach's α values 0.77-0.93). The item response rate was 99%. Intra-class correlations (ICC) were strong for PFDI-20 and PFIQ-7 and their subscales ranged from 0.86 to 0.96. Construct validity of the tools demonstrated by manyfold higher scores among patients with POP compared with women without POP (p<0.0001). CONCLUSIONS The Estonian versions of the PFDI-20 and PFIQ-7 tools are reliable and valid instruments for assessing the quality of life in women with POP.
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Affiliation(s)
- Iveta Mikeltadze
- Department of Surgical and Gynecological Oncology, Tartu University Hospital, Puusepa Street 8, 50406, Tartu, Estonia
- Institute of Clinical Medicine, University of Tartu, Puusepa Street 8, 50406, Tartu, Estonia
| | - Katrin Täär
- Women's Clinic of Tartu University Hospital, Puusepa Street 8, 50406, Tartu, Estonia
| | - Ülle Kadastik
- Women's Clinic of Tartu University Hospital, Puusepa Street 8, 50406, Tartu, Estonia
| | - Pille Soplepmann
- Women's Clinic of Tartu University Hospital, Puusepa Street 8, 50406, Tartu, Estonia
| | - Kristiina Rull
- Institute of Clinical Medicine, University of Tartu, Puusepa Street 8, 50406, Tartu, Estonia.
- Women's Clinic of Tartu University Hospital, Puusepa Street 8, 50406, Tartu, Estonia.
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Mashayekh-Amiri S, Asghari Jafarabadi M, Rashidi F, Mirghafourvand M. Translation and measurement properties of the pelvic floor distress inventory-short form (PFDI-20) in Iranian reproductive age women. BMC Womens Health 2023; 23:333. [PMID: 37355567 PMCID: PMC10290403 DOI: 10.1186/s12905-023-02493-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/20/2023] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND Every year, millions of women worldwide suffer in silence from pelvic floor disorders (PFDs) as an annoying health problem. Despite the high prevalence rate and negative effects of PFDs on the quality of life, the validity and reliability of pelvic floor distress inventory-short form (PFDI-20) has not been confirmed for Iranian women of reproductive age. Hence, this study aimed to determine measurement properties of PFDI-20 among women of reproductive age in Tabriz, Iran. METHODS The current study was cross-sectional research that selected 400 women of reproductive age referring to health centers in Tabriz City, by using cluster random sampling from May 2022 to September 2022. Measurement properties of the Persian version of PFDI-20 were determined and evaluated through five steps, including content and face validity within two quantitative and qualitative parts, structural validity by using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and reliability testing through internal consistency, test-retest reliability, and measurement error. Moreover, ceiling and floor effects were investigated. RESULTS In this research, CVI (content validity index) and CVR (content validity ratio) of PFDI-20 equaled 0.94 and 0.97, respectively. In addition, the EFA process was applied to 20 items and derived the structure of three factors, which explained 58.15% of the total variance. In CFA phase, values of fit indicators (RMSEA = 0.07, SRMR = 0.07, TLI = 0.97, CFI = 0.99, x2/df = 3.19) confirmed the model validity. To determine reliability, Cronbach's alpha = 0.84; McDonald's omega (95% CI) = 0.84 (0.82 to 0.87) and Intraclass Correlation Coefficient (95% CI) = 0.98 (0.97 to 0.99) were obtained. Also, the SEM was 2.64, and the SDC indicating the smallest individual change was 8.91. Regarding the inventory feasibility, the ceiling effect was not observed in total value and subscales, while the floor effect in the total score of PFDI-20 equaled 24.0. The latter rate equaled 45.8, 38.3, and 50.8 for subscales POPDI-6, CRADI-8, and UDI-6, respectively. CONCLUSIONS Persian version of PFDI-20 is a valid and reliable scale used to evaluate PFDs in Iranian women of reproductive age. Healthcare professionals can use this scale to screen PFDs, and researchers can consider it a reliable tool for their studies.
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Affiliation(s)
- Sepideh Mashayekh-Amiri
- Students Research Committee, Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Cabrini Research, Cabrini Health, Melbourne, VIC 3144 Australia
- School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3800 Australia
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Rashidi
- Students Research Committee, Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
- Menopause Andropause Research Center, Ahvaz Jundishapur, University of Medical Sciences, Ahvaz, Iran
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Morciano A, Ercoli A, Caliandro D, Campagna G, Panico G, Giaquinto A, Zullo MA, Tinelli A, Scambia G, Marzo G, Cervigni M. Laparoscopic posterior vaginal plication plus sacral colpopexy for severe posterior vaginal prolapse: A randomized clinical trial. Neurourol Urodyn 2023; 42:98-105. [PMID: 36135387 DOI: 10.1002/nau.25052] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 09/09/2022] [Indexed: 01/03/2023]
Abstract
AIM A randomized clinical trial proposing a new laparoscopic prosthetic and fascial approach to severe posterior vaginal prolapse. The primary endpoint was to evaluate the objective and subjective outcomes of our laparoscopic posterior plication (LPP) combined to "two-mesh" sacral colpopexy (laparoscopic sacral colpopexy [LSC]) in severe posterior vaginal prolapse, with a 1-year follow-up. The secondary endpoint was to evaluate the safety of this surgical procedure. METHODS This is single-center prospective randomized double-blinded clinical trial. A total of 130 consecutive patients with anterior and/or apical pelvic organ prolapse (POP) (POP-Q stage ≥II) and severe posterior vaginal prolapse (posterior POP-Q stage ≥III) were prospectively assessed for inclusion into the study from November 2018 to January 2020. Patients underwent "two-meshes" LSC and were randomized in Group A (LSC plus LPP) and Group A (LSC alone). Of the 130 included subjects, 8 were excluded, not meeting inclusion criteria. Cure rate was evaluated objectively, using POP-Q study, and subjectively using PGI-I, POPDI-6, and FSDS questionnaires. Complications were assessed intra-, peri-, and postoperatively. Twelve-month follow-ups were analyzed for the study. RESULTS We found in LSC plus LPP Group a significant improvement of Ap and genital hiatus POP-Q points. Our subjective study showed, at 12 months, a statistical difference in PGI-I successful outcomes rate in favor of LPP. Also the FSDS resulted significantly much more improved in Group A. We observed no statistical differences in terms of postoperative complications. CONCLUSIONS Our LPP approach to LSC could be considered an effective and safe technique to POP patients with severe posterior prolapse.
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Affiliation(s)
- Andrea Morciano
- Department of Gynaecology and Obstetrics, Panico Pelvic Floor Center, Pia Fondazione "Card. G. Panico", Tricase, Lecce, Italy
| | - Alfredo Ercoli
- Department of Gynaecology and Obstetrics, Università degli Studi di Messina, Messina, Italy
| | - Dario Caliandro
- Department of Gynaecology and Obstetrics, Panico Pelvic Floor Center, Pia Fondazione "Card. G. Panico", Tricase, Lecce, Italy
| | - Giuseppe Campagna
- Department of Gynaecology and Obstetrics, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Roma, Italy
| | - Giovanni Panico
- Department of Gynaecology and Obstetrics, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Roma, Italy
| | - Alessia Giaquinto
- Department of Gynaecology and Obstetrics, Panico Pelvic Floor Center, Pia Fondazione "Card. G. Panico", Tricase, Lecce, Italy
| | - Marzio Angelo Zullo
- Department of Surgery-Week Surgery, University "Campus Biomedico", Roma, Italy
| | - Andrea Tinelli
- Department of Gynaecology and Obstetrics, "Veris Delli Ponti Hospital", Scorrano, Lecce, Italy
| | - Giovanni Scambia
- Department of Gynaecology and Obstetrics, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Roma, Italy
| | - Giuseppe Marzo
- Department of Gynaecology and Obstetrics, Panico Pelvic Floor Center, Pia Fondazione "Card. G. Panico", Tricase, Lecce, Italy
| | - Mauro Cervigni
- Department of Urology, Università "La Sapienza", ICOT-Latina, Latina, Italy
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de Arruda GT, de Andrade DF, Virtuoso JF. Internal structure and classification of pelvic floor dysfunction distress by PFDI-20 total score. J Patient Rep Outcomes 2022; 6:51. [PMID: 35576026 PMCID: PMC9109438 DOI: 10.1186/s41687-022-00459-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 05/03/2022] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To evaluate the internal structure (structural validity and internal consistency) and propose a classification for the distress caused by the presence of pelvic floor dysfunction (PFD) symptoms based on the total score of the Pelvic Floor Distress Inventory (PFDI-20). METHODS Cross-sectional study conducted with Brazilian women over 18 years of age. Exploratory and confirmatory factor analysis were performed with Parallel Analysis and to test three models to compare them with the Root Mean Square Error of Approximation (RMSEA) and Comparative Fit Index (CFI). Internal consistency was calculated using Cronbach's alpha. Partial credit model (PCM) was performed to classify the total score of the PFDI-20. RESULTS Data from 237 women (49.62 ± 16.95 years) were analyzed. The one-dimensional structure had 43.74% of the explained variance with α = 0.929. The one-dimensional model was the most appropriate (CFI = 0.987 and RMSEA = 0.022). The total PFDI-20 score was classified as the absence of symptoms (score zero), symptoms with mild distress (1 to 15 points), symptoms with moderate distress (16 to 34 points), and symptoms with severe distress (35 to 40 points). CONCLUSION The PFDI-20 has an one-dimensional structure and the distress caused by the presence of PFD symptoms can be classified as mild, moderate and severe. Health professionals and future studies can use our classification to facilitate the understanding of the patient's health status and to obtain other analyses on the severity of the distress of the symptoms of PFD.
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Affiliation(s)
- Guilherme Tavares de Arruda
- Departament of Physical Therapy, Universidade Federal de São Carlos, Rod. Washington Luiz, s/n, São Carlos, SP, CEP: 13565-905, Brazil.
| | | | - Janeisa Franck Virtuoso
- Department of Health Sciences and Technology, Universidade Federal de Santa Catarina, Araranguá, Brazil
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Biomechanical integrity score of the female pelvic floor. Int Urogynecol J 2022; 33:1617-1631. [PMID: 35230483 PMCID: PMC9206610 DOI: 10.1007/s00192-022-05120-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/03/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The aim of this study is to develop and validate a new integral parameter, the Biomechanical Integrity score (BI-score), for the characterization of the female pelvic floor. METHODS A total of 253 subjects with normal and pelvic organ prolapse (POP) conditions were included in the multi-site observational, case-control study; 125 subjects had normal pelvic floor conditions, and 128 subjects had POP stage II or higher. A Vaginal Tactile Imager (VTI) was used to acquire and automatically calculate 52 biomechanical parameters for eight VTI test procedures (probe insertion, elevation, rotation, Valsalva maneuver, voluntary muscle contractions in two planes, relaxation, and reflex contraction). Statistical methods were applied (t-test, correlation) to identify the VTI parameters sensitive to the pelvic conditions. RESULTS Twenty-six parameters were identified as statistically sensitive to POP development. They were subdivided into five groups to characterize (1) tissue elasticity, (2) pelvic support, (3) pelvic muscle contraction, (4) involuntary muscle relaxation, and (5) pelvic muscle mobility. Every parameter was transformed to its standard deviation units against the patient age similar to T-score for bone density. Linear combinations with specified weights led to the composition of five component parameters for groups (1)-(5) and the BI-score in standard deviation units. The p-value for the BI-score has p = 4.3 × 10-31 for POP versus normal conditions. A reference BI-score curve against age for normal pelvic floor conditions was defined. CONCLUSIONS Quantitative transformations of the pelvic tissues, support structures, and functions under diseased conditions may be studied with the BI-score in future research and practical applications.
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