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Sigurdardottir T, Steingrimsdottir T, Geirsson RT, Halldorsson TI, Aspelund T, Bø K. Postpartum pelvic organ prolapse and pelvic floor muscle training: secondary analysis of a randomized controlled trial of primiparous women. Int Urogynecol J 2023:10.1007/s00192-023-05502-8. [PMID: 36995416 DOI: 10.1007/s00192-023-05502-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 02/02/2023] [Indexed: 03/31/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Pelvic floor dysfunction is common after childbirth. We hypothesize that physiotherapist-guided pelvic floor muscle training (PFMT) is effective regarding pelvic organ prolapse (POP) symptoms during the first postpartum year. METHODS This was a secondary analysis from a randomized controlled trial (RCT), carried out at a physiotherapy clinic, Reykjavik. Participants were eighty-four primiparous women with a singleton delivery. They were screened for eligibility 6-13 weeks postpartum. Women in a training group conducted 12 weekly individual sessions with a physiotherapist within an RCT, starting on average 9 weeks postpartum. Outcomes were assessed after the last session (short term) and at approximately 12 months postpartum (long term). The control group received no instructions after the initial assessment. Main outcome measures were self-evaluated POP symptoms by the Australian Pelvic Floor Questionnaire. RESULTS Forty-one and 43 women were in the training and control groups, respectively. At recruitment, 17 (42.5%) of the training group and 15 (37%) of the control group reported prolapse symptoms (p = 0.6). Five (13%) from the training group and nine (21%) controls were bothered by the symptoms (p = 0.3). There was a gradual decrease in the number of women with symptoms and no significant short-term (p = 0.08) or long-term (p = 0.6) differences between the groups regarding rates of women with POP symptoms. The difference between groups regarding bother in the short (p = 0.3) or longer term (p = 0.4) was not significant. Repeated-measures analyses using Proc Genmod in SAS did not indicate a significant effect of the intervention over time (p > 0.05). CONCLUSIONS There was an overall decrease in postpartum symptoms of POP and bother during the first year. Physiotherapist-led PFMT did not change the outcomes. CLINICAL TRIAL REGISTRATION The trial was registered 30 March 2015 at https://register. CLINICALTRIALS gov (NCT02682212). Initial participant enrollment was on 16 March 2016 and reported following CONSORT guidelines for randomized controlled trials.
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Affiliation(s)
- Thorgerdur Sigurdardottir
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
- Department of Obstetrics and Gynecology, Landspitali University Hospital, Reykjavik, Iceland.
| | - Thora Steingrimsdottir
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
- Department of Obstetrics and Gynecology, Landspitali University Hospital, Reykjavik, Iceland
| | - Reynir T Geirsson
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
- Department of Obstetrics and Gynecology, Landspitali University Hospital, Reykjavik, Iceland
| | - Thorhallur I Halldorsson
- Faculty of Food Sciences and Nutrition, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Thor Aspelund
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Kari Bø
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway
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Effects of the Oxytocin Hormone on Pelvic Floor Muscles in Pregnant Rats. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020234. [PMID: 36837436 PMCID: PMC9962430 DOI: 10.3390/medicina59020234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/02/2023] [Accepted: 01/06/2023] [Indexed: 01/28/2023]
Abstract
Background and Objectives: Oxytocin induction is a known risk factor for pelvic floor disorders (PFDs). The aim of the study was to investigate the effects of oxytocin induction on pelvic floor muscles in pregnant rats. Methods: Thirty-two female Wistar rats were included and divided into four groups (n = 8). The groups were as follows: virgin group (group I)-from which muscles were dissected at the beginning of the experiment; spontaneous vaginal delivery (group II) which has delivery spontaneously; saline control group (group III) and oxytocin group (group IV). In groups III and IV, pregnancy was induced on d 21 of pregnancy, with 2.5 mU saline solution or iv oxytocin, respectively, delivered by the intravenous (iv) route in pulses at 10-min intervals for 8 h. Then, the rats were euthanized, the m. coccygeus, m. iliocaudalis and m. pubocaudalis muscles were excised and tissue samples were taken. After histological processing, the vertical and horizontal dimensions of the muscles were analyzed under a light microscope. Results: In group IV; the measurement of the horizontal dimension of the m. pubocaudalis muscles was 50.1 ± 5.4 µm and it was significantly higher than other groups (p < 0.001). In group III; the mean value of the horizontal dimension of m. coccygeus muscle was found to be 49.5 ± 10.9 µm and it was significantly higher than other groups (p < 0.009). Between-group comparisons revealed no difference in mean m. iliocaudalis muscle dimension (p > 0.05). Conclusions: As a result of our study it can say that whether oxytocin induced or not, vaginal birth is a process that affects the pelvic muscles.
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Brülle AL, Wu C, Rasch V, Simonsen MK, Schøyen IS, Dahl C, Nohr EA. How do reproductive history and anthropometry in midlife relate to later risk of pelvic organ prolapse? A prospective cohort study. Int Urogynecol J 2022; 33:3373-3380. [PMID: 35254470 DOI: 10.1007/s00192-022-05122-8] [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: 11/24/2021] [Accepted: 02/03/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The objective was to examine the association between reproductive and anthropometric factors and later risk of pelvic organ prolapse (POP). METHODS We carried out a prospective cohort study including 11,114 female nurses > 44 years from the Danish Nurse Cohort. In 1993, the study population was recruited through the Danish Nurse Organization and self-reported data on age, height, weight, age at menarche, age at first birth and number of childbirths were obtained. POP diagnosis was obtained from the National Patient Registry. Risk of POP was estimated using COX regression and presented as hazard ratios (HR) with 95% confidence intervals (CI). RESULTS Overall, 10% of the women received a diagnosis of POP within a median follow-up of 22 years. A 4% increase in risk of POP was seen for each increasing BMI (kg/m2) unit at baseline. Compared to women of normal weight, higher risks of POP were seen in overweight (HR 1.18: 1.02-1.36) and obese women (HR 1.33: 1.02-1.74), while underweight had a lower risk (HR 0.51: 0.27-0.95). Compared to women with one childbirth, women with no childbirths had a reduced risk of 57% while increased risks of 46%, 78% and 137% were observed in women with two, three and four childbirths. Women with menarche before the age of 12 tended to have a higher risk of POP as did women who were 30-33 years at their first childbirth. CONCLUSIONS POP is a common health problem in women, and BMI and number of childbirths are strong predictors.
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Affiliation(s)
- Anne-Line Brülle
- Occupational and Environmental Medicine, Odense University Hospital, J.B. Winsløws Vej 4, 5000, Odense C, Denmark.
| | - Chunsen Wu
- Institute of Clinical Research, University of Southern Denmark, Winsløwparken 19, 5000, Odense C, Denmark
- Department of Gynaecology and Obstetrics, Odense University Hospital, Kløvervænget 23, 5000, Odense C, Denmark
| | - Vibeke Rasch
- Institute of Clinical Research, University of Southern Denmark, Winsløwparken 19, 5000, Odense C, Denmark
- Department of Gynaecology and Obstetrics, Odense University Hospital, Kløvervænget 23, 5000, Odense C, Denmark
| | - Mette Kildevæld Simonsen
- Department of Neurology and Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Ine Schmidt Schøyen
- Department of Gynaecology and Obstetrics, Sørlandet Sykehus HF, Kristiansand, Norway
| | - Carina Dahl
- Department of Paediatrics, Sørlandet Sykehus HF, Kristiansand, Norway
| | - Ellen Aagaard Nohr
- Institute of Clinical Research, University of Southern Denmark, Winsløwparken 19, 5000, Odense C, Denmark
- Department of Gynaecology and Obstetrics, Odense University Hospital, Kløvervænget 23, 5000, Odense C, Denmark
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Sori DA, Bretones S, Mellier G, de Rochambeau B. Prevalence and surgical outcomes of stage 3 and 4 pelvic organs prolapse in Jimma university medical center, south west Ethiopia. BMC Womens Health 2022; 22:410. [PMID: 36207709 PMCID: PMC9540999 DOI: 10.1186/s12905-022-01992-8] [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: 04/29/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022] Open
Abstract
Background Pelvic organ prolapse (POP) affects about half of the women and affects their quality of life. The current study is, therefore, aimed at determining the prevalence and surgical outcomes of severe stage POP at Jimma University medical center from November 2016 to May 2018.
Method A Hospital-based cross-sectional study was conducted on all patients with stage 3 and 4 POP, who were admitted, and had surgery. Data were collected from the patient’s chart, and logbooks, which were filled up from entry till her discharge. A Simplified POPQ(S-POPQ) was used to stage the prolapse at admission, at discharge, and three months follow-ups.
Results Among 92 patients who were analyzed, POP accounts for 10.6% of all gynecologic admissions, and 43.8% of all gynecologic surgeries. The mean age of patients is 46 (± 12) years, and nearly 34% of the patients had stage 3 and 66% had stage 4 POP. Based on the type of prolapse, 93.5% of patients had stage 3 and more anterior vaginal wall prolapse (AVWP) and apical prolapse, while 57.6% had stage 3 or more posterior vaginal wall prolapse. Out of 72 patients who had anterior colporrhaphy, 58.7% had anterior colporrhaphy with colposuspension. Out of 83 patients who had apical suspension, 48.2%, 39.8%, and 12% had uterosacral, sacrospinous, and Richardson respectively. Ninety-seven patients had stage 0 or 1 POP at discharge while 90% of 20 patients who returned for follow-up at three months had stage 0 or 1 POP. Eight patients had surgery-related complications; bladder injury, urinary retention, Hemorrhage during SSLF, and rectal injury. Conclusion The prevalence of pelvic organ prolapse is high and the majority of patients presented with advanced-stage pelvic organ prolapse, with a long duration of symptoms and associated problems. The surgical techniques used have resulted in a high immediate success rate of 97% and 90% at discharge and three months follow up respectively. Therefore, awareness creation activities are important to facilitate an early presentation for treatment to improve the quality of life and the current surgical technique; native tissue vaginal repair (NTVR), being practiced in the setup has had better success.
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Affiliation(s)
- Demisew Amenu Sori
- grid.411903.e0000 0001 2034 9160Jimma University Institute of Health, Department of Obstetrics and Gynecology, Jimma University, Jimma, Ethiopia
| | - Stephan Bretones
- Urogynecology and Reconstructive Pelvic Surgeon, Saint Joseph-Saint Luc Hospital, Lyon, France
| | - Georges Mellier
- grid.7849.20000 0001 2150 7757Department of Obstetrics and Gynecology, Lyon 1 University, Villeurbanne, France
| | - Bertrand de Rochambeau
- Urogynecology and Reconstructive Pelvic Surgeon, Saint Joseph-Saint Luc Hospital, Lyon, France
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Fang J, Ye J, Huang Q, Lin Y, Weng Y, Wang M, Chen Y, Lu Y, Zhang R. Risk factors of pelvic floor muscle strength in south Chinese women: a retrospective study. BMC Pregnancy Childbirth 2022; 22:624. [PMID: 35933360 PMCID: PMC9356495 DOI: 10.1186/s12884-022-04952-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 07/26/2022] [Indexed: 12/31/2022] Open
Abstract
Objectives To evaluate pelvic floor muscle strength using surface electromyography and risk factors for pelvic floor muscle strength in the early postpartum period. Methods This retrospective study included 21,302 participants who visited Fujian
Maternity and Child Health Hospital from September 2019 to February 2022. All participants
were assessed by
medical professionals for general information and surface electromyography. Results Univariate analysis indicated that age was inversely related to tonic and endurance contractions. In contrast, all the other variables, including education level, body mass index, neonatal weight, and number of fetuses, had a positive impact on rapid, tonic, and endurance contractions. Likewise, parity was also positively associated with rapid contractions. In addition, compared with vaginal delivery, cesarean section delivery had a protective effect on the amplitude of the three types of contractions. Stepwise regression analysis showed that both age and neonatal weight had a negative linear relationship with the amplitude of rapid, tonic and endurance contractions. In contrast, the amplitude of rapid, tonic and endurance contractions significantly increased as body mass index, parity (≤ 3), education level and gestational weight gain (endurance contractions only) increased. Participants with cesarean section delivery showed positive effects on rapid, tonic, and endurance contractions compared to participants with vaginal delivery. Conclusions We found that age, neonatal weight, vaginal delivery, episiotomy, and forceps delivery were risk factors for pelvic floor muscle strength; in contrast, body mass index, parity (≤ 3) and gestational weight gain had a positive relationship with pelvic floor muscle strength.
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Affiliation(s)
- Jianqi Fang
- Department of Women's Health Care, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, 350000, People's Republic of China.,Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, People's Republic of China
| | - Jiajia Ye
- Department of Rehabilitation Assessment, Rehabilitation Hospital, Fujian University of Traditional Chinese Medicine, Fujian, 350000, Fuzhou, People's Republic of China
| | - Qing Huang
- College of Environment and Public Health, Xiamen Huaxia University, Xiamen Fujian, People's Republic of China
| | - Yang Lin
- Department of Women's Health Care, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, 350000, People's Republic of China.,Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, People's Republic of China
| | - Yilin Weng
- Department of Women's Health Care, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, 350000, People's Republic of China.,Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, People's Republic of China
| | - Miao Wang
- Department of Women's Health Care, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, 350000, People's Republic of China.,Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, People's Republic of China
| | - Yi Chen
- Department of Women's Health Care, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, 350000, People's Republic of China.,Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, People's Republic of China
| | - Yao Lu
- Department of Women's Health Care, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, 350000, People's Republic of China.,Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, People's Republic of China
| | - Ronghua Zhang
- Department of Women's Health Care, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, 350000, People's Republic of China. .,Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, People's Republic of China.
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Qin Z, Dong Z, Tang H, Zhang S, Wang H, Bao M, Wei W, Shi R, Chen J, Xia B. A preliminary clinical report of transvaginal natural orifice transluminal endoscopic Sacrospinous Ligament Fixation in the treatment of moderate and severe pelvic organ prolapse. Front Surg 2022; 9:931691. [PMID: 35965861 PMCID: PMC9372293 DOI: 10.3389/fsurg.2022.931691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022] Open
Abstract
Objective To study the efficacy and safety of transvaginal natural orifice transluminal endoscopic Sacrospinous Ligament Fixation in the treatment of moderate and severe pelvic organ prolapse. Design Patients were selected into this study on a voluntary basis to evaluate the short-term efficacy of this surgery by comparing the OP-Q scores before the operation, three months after the operation, and six months after the operation. Setting and Patients Evaluate the clinical efficacy and safety by a retrospective analysis of the clinical data of the 18 patients with POP-Q grade III–IV pelvic organ prolapse treated by the Department of Gynecology of Nanjing Medical University Affiliated Changzhou No.2 People's Hospital from April 2020 to November 2020, and their post-operation follow-ups. Interventions Patients with postoperative follow-ups found no obvious relapse without intervention measures. Measurements and Main Results The transvaginal natural orifice transluminal endoscopic Sacrospinous Ligament Fixation was performed successfully, and the anterior and posterior walls of vagina and/or trans-vaginal hysterectomy were repaired as appropriate. Except the total vaginal length (TVL), the P values of numerical analysis for all points before, three months after, and six months after the operation were all <0.05, being statistically significant. Conclusion This method is effective in the treatment of moderate and severe pelvic organ prolapse with few complications, but more cases and longer-term follow-up data are needed to determine the long-term effect of this procedure. For the selection of puncture sites, more anatomical data are needed to get more accurate result.
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Affiliation(s)
| | - Zhiyong Dong
- Department of Gynecology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Huimin Tang
- Department of Gynecology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | | | | | | | - Weiwei Wei
- Department of Gynecology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Ruxia Shi
- Department of Gynecology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Jiming Chen
- Department of Gynecology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
- Correspondence: Jiming Chen Bairong Xia
| | - Bairong Xia
- Department of Gynecology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Correspondence: Jiming Chen Bairong Xia
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Özen İ, Wang X. Biomedicine: electrospun nanofibrous hormonal therapies through skin/tissue—a review. INT J POLYM MATER PO 2021. [DOI: 10.1080/00914037.2021.1985493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- İlhan Özen
- Textile Engineering Department, Erciyes University, Melikgazi, Kayseri, Turkey
| | - Xungai Wang
- Institute for Frontier Materials, Deakin University, Geelong, Australia
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Guo KM, He LC, Feng Y, Huang L, Morse AN, Liu HS. Surface electromyography of the pelvic floor at 6-8 weeks following delivery: a comparison of different modes of delivery. Int Urogynecol J 2021; 33:1511-1520. [PMID: 34132864 DOI: 10.1007/s00192-021-04789-9] [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: 11/13/2020] [Accepted: 03/24/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The objective of this study was to compare the impact of different modes of delivery, especially forceps delivery (FD), on pelvic floor muscles (PFMs) through vaginal surface electromyography (sEMG) in primiparous women at early (6-8 weeks) postpartum. METHODS A total of 1259 primiparous women with full-term singleton births were included in this cross-sectional study. Of these, 98 were delivered by forceps, 865 underwent spontaneous vaginal delivery (SD) and 296 underwent elective cesarean delivery (CD). Clinical demographic characteristics and vaginal sEMG variables of parturients 6-8 weeks after birth were collected and analyzed using SPSS software. One-way ANOVA with Bonferroni correction, Chi-square test or Student's t-test was used according to the variable type. Spearman correlation and binary logistic regression analyses were also used. P/α ≤ 0.05 was considered statistically significant. RESULTS Amplitude of fast and sustained contractions on sEMG in the FD group was significantly lower compared with the CD and SD groups. The sEMG amplitude of all contractions was significantly higher in the CD group compared with the FD and SD groups (P < 0.01). According to binary logistic regression analysis, mode of delivery was a major influencing factor in sEMG. CONCLUSIONS An early postpartum sEMG test appears to be helpful for the assessment of PFM activity. Mode of delivery was a major influencing factor on sEMG. Forceps delivery significantly inversely influenced PFM activity.
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Affiliation(s)
- Kai-Min Guo
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Jinan University, Guangzhou, 510630, People's Republic of China.,Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Tianhe District, Guangzhou, Guangdong Province, 510623, People's Republic of China
| | - Lang-Chi He
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Tianhe District, Guangzhou, Guangdong Province, 510623, People's Republic of China
| | - Yan Feng
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Tianhe District, Guangzhou, Guangdong Province, 510623, People's Republic of China
| | - Liu Huang
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Tianhe District, Guangzhou, Guangdong Province, 510623, People's Republic of China
| | - Abraham Nick Morse
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Tianhe District, Guangzhou, Guangdong Province, 510623, People's Republic of China
| | - Hui-Shu Liu
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Tianhe District, Guangzhou, Guangdong Province, 510623, People's Republic of China.
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Cross-sectional study of early postpartum pelvic floor dysfunction and related bother in primiparous women 6-10 weeks postpartum. Int Urogynecol J 2021; 32:1847-1855. [PMID: 33938963 DOI: 10.1007/s00192-021-04813-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 04/18/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION AND HYPOTHESIS To study the prevalence of pelvic floor dysfunction and related bother in primiparous women 6-10 weeks postpartum, comparing vaginal and cesarean delivery. METHODS Cross-sectional study of 721 mothers with singleton births in Reykjavik, Iceland, 2015 to 2017, using an electronic questionnaire. Information on urinary and anal incontinence, pelvic organ prolapse and sexual dysfunction with related bother (trouble, nuisance, worry, annoyance) was collected. Main outcome measures were prevalence of pelvic floor dysfunction and related bother. RESULTS The overall prevalence of urinary and anal incontinence was 48% and 60%, respectively. Bother regarding urinary symptoms was experienced by 27% and for anal symptoms by 56%. Pelvic organ prolapse was noted by 29%, with less than half finding this bothersome. Fifty-five percent were sexually active, of whom 66% reported coital pain. Of all the women, 48% considered sexual issues bothersome. Urinary incontinence and pelvic organ prolapse were more prevalent in women who delivered vaginally compared to cesarean section, but no differences were observed for anal incontinence and coital pain. Compared to women with BMI < 25, obesity was a predictor for urinary incontinence after vaginal delivery (OR 1.94; 95% CI 1.20-3.14). Birthweight > 50th percentile was predictive for urgency incontinence after vaginal delivery (OR 1.53; 95% CI 1.05-2.21). Episiotomy predicted more anal incontinence (OR 2.19; 95% CI 1.30-3.67). No associations between maternal and delivery characteristics were found for pelvic floor dysfunction after cesarean section. CONCLUSIONS Bothersome pelvic floor dysfunction symptoms are prevalent among first-time mothers in the immediate postpartum period.
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Zenebe CB, Chanie WF, Aregawi AB, Andargie TM, Mihret MS. The effect of women's body mass index on pelvic organ prolapse: a systematic review and meta analysis. Reprod Health 2021; 18:45. [PMID: 33608022 PMCID: PMC7893921 DOI: 10.1186/s12978-021-01104-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 02/09/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Pelvic organ prolapse remains the public health challenge globally. Existing evidences report the effect of woman's weight on the pelvic organ prolapse inconsistently and this urges the need of pooled body weight effect on the pelvic organ prolapse. Although there was a previous work on this regard, it included papers reported before June 18/2015. Thus, updated and comprehensive evidence in this aspect is essential to devise strategies for interventions. OBJECTIVE This review aimed at synthesizing evidence regarding the pooled effect of body weight on the pelvic organ prolapsed. METHODS For this review, we searched all available articles through databases including PubMed, Web of Sciences, CINAHL, JBI library, Cochran library, PsycInfo and EMBASE as well as grey literature including Mednar, worldwide science, PschEXTRA and Google scholar. We included cohort, case-control, cross-sectional and experimental studies which had been reported between March 30, 2005 to March 30, 2020. In the effect analysis, we utilized random model. The heterogeneity of the studies was determined by I2 statistic and the publication bias was checked by Egger's regression test. Searching was limited to studies reported in the English language. RESULTS A total of 14 articles with 53,797 study participants were included in this systematic review (SR) and meta analysis (MA). The pooled result of this Meta analyses depict that body mass index (BMI) doesn't have statistical significant association with pelvic organ prolapse. CONCLUSION This review point out that women's body mass index has no significant effect on the development of pelvic organ prolapse. However, the readers should interpret the result with cautions due to the presence of considerable limitations in this work. Trial registration The protocol of this systematic review (SR) and meta analysis (MA) has been registered in PROSPERO databases with the Registration number of CRD42020186951.
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Affiliation(s)
- Chernet Baye Zenebe
- Gynecology and Obstetrics Department, University of Gondar, Gondar, Ethiopia
| | - Wagaye Fentahun Chanie
- United Nations Population Fund Supported Maternal Health Project, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | | | | | - Muhabaw Shumye Mihret
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Po. Box 196, Gondar, Ethiopia.
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Family history and pelvic organ prolapse: a systematic review and meta-analysis. Int Urogynecol J 2020; 32:759-774. [PMID: 33084962 DOI: 10.1007/s00192-020-04559-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 10/02/2020] [Indexed: 01/21/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Numerous analytic observational studies assess family history as a risk factor for POP and report a wide range of associations. This review aims to systematically evaluate the role of family history of POP in relation to POP risk and its recurrence. METHODS A review was performed of the PubMed/MEDLINE database with search criteria specifying family history, risk factors, POP, and their synonyms as title/abstract keywords, as well as MESH terms, up to March 2020. We aggregated evidence across studies with fixed effects (FE) and random effects (RE) meta-analysis. RESULTS Forty-three articles underwent full-text review. Eighteen independent studies evaluating the relationship between family history of POP and POP risk in 3639 POP cases and 10,912 controls were eligible for meta-analysis. Four studies evaluating family history and POP recurrence in 224 recurrent cases and 400 non-recurrent cases were eligible for inclusion into another meta-analyses. A positive family history of POP is on average associated with 2.3- to 2.7-fold increased risk for POP (RE OR = 2.64; 95% CI = 2.07, 3.35) as well as a 1.4-fold increased risk for POP recurrence (FE OR = 1.44; 95% CI = 1.00, 2.08). Meta-analysis estimates of POP risk varied by study design, definition of family history, and model adjustment status. We found evidence that publication bias and recall bias are a possibility. CONCLUSIONS Family history of POP is a risk factor for both POP presence and recurrence. However, reported magnitudes may be overestimates due to confounding, recall bias, and publication bias.
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Meutia AP, Triyarintana A. Anatomical Outcome After Sacrospinous Fixation Procedure on Pelvic Organ Prolapse Cases in Cipto Mangunkusumo Hospital Year 2013–2018. J Gynecol Surg 2020. [DOI: 10.1089/gyn.2020.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Alfa P. Meutia
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Adia Triyarintana
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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13
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Wu PC, Hsiao SM, Chen CH, Lin HH. Comparison of the vault prolapse rate after vaginal hysterectomy with or without residual uterine ligament ligations: A retrospective cohort study. J Formos Med Assoc 2019; 119:805-812. [PMID: 31813655 DOI: 10.1016/j.jfma.2019.11.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 11/13/2019] [Accepted: 11/19/2019] [Indexed: 10/25/2022] Open
Abstract
PURPOSE To evaluate the post-hysterectomy vault prolapse (PHVP) rates performed using different methods of vaginal total hysterectomy (VTH). METHODS A total of 251 women who underwent VTH with/without concomitant surgeries between January 1986 and December 2001 in a tertiary center. Thirty-eight women were excluded due to not only a vaginal approach. Of the remaining 213 women, 129 and 84 underwent VTH via the Tsuzi method with residual uterine ligament ligations (ligations group) and traditional VTH (without ligations group), respectively. The χ2 and Mann-Whitney U tests were applied appropriately. The cumulative percentages of women without PHVP were calculated over time and compared using Kaplan-Meier curves and log-rank tests. A p value of less than 0.05 was considered statistically significant. RESULTS Compared to the without ligations group, women in the ligations group had longer operation time (115.9 ± 37.1 vs. 103.3 ± 41.4 min, p = 0.002) and more blood loss (217.4 ± 137.8 vs. 148.2 ± 149.0 mL, p < 0.001). When focusing on women with uterine prolapse, only operation time and grade of uterine prolapse were different between the groups (117.3 ± 24.8 vs. 107.9 ± 40.5 min, p = 0.025, and 21% vs. 41%, p = 0.018, respectively). The rate of PHVP was significantly lower in the ligation group than in the without ligations group (0 vs. 5, p = 0.005). CONCLUSION VTH via the Tsuzi method with residual uterine ligament ligations resulted in fewer cases of PHVP than occurred in traditional VTH. If native tissue repair is planned in pelvic reconstruction surgery, VTH with residual uterine ligament ligations should be considered.
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Affiliation(s)
- Pei-Chi Wu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan; Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan
| | - Chi-Hau Chen
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan.
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14
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Azevedo IG, Sousa SLDO, Viana EDSR, Dantas DDS, Maciel ÁCC, Da Câmara SMA. Relationship between symptomatic pelvic organ prolapse and respiratory muscle strength in middle-aged and older women in Northeast Brazil: a cross-sectional study. Physiother Theory Pract 2019; 37:755-761. [PMID: 31294670 DOI: 10.1080/09593985.2019.1642428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Some respiratory muscles work in synergy with the pelvic floor (PF). Pelvic organ prolapse (POP) is characterized by weak PF muscles and has been associated with worse pulmonary ventilation function in women. To date no studies have investigated the association between respiratory muscle strength and POP. This study aimed to determine whether symptomatic POP is associated with respiratory muscle strength in middle-aged and older women. In this observational cross-sectional study, 204 community-dwelling women (41-80 years old) from Santa Cruz (Northeastern Brazil) provided information on socioeconomic characteristics, health behavior, reproductive history and symptomatic POP via a structured questionnaire. A digital manometer was used to measure their maximal inspiratory and expiratory pressures (MIP and MEP). Multiple linear regression analyses, adjusted for covariates (age, income, education, body mass index, and smoking), evaluated the association between POP and MIP/MEP. The results show that 14.7% of the sample reported symptomatic POP. These women exhibited lower mean MIP and MEP than those reporting no POP, but the intergroup difference was only significant for MEP (p = .01). The association between POP and MEP remained statistically significant, even after covariates (β = 11.9, p = .04) were adjusted. Symptomatic POP is associated with expiratory muscle strength in middle-aged and older women. This innovative research provides important information regarding the need to evaluate the integrity of PF muscles when assessing respiratory muscle strength, which may help clinicians devise preventive and treatment strategies to improve women's health during the aging process.
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Affiliation(s)
- Ingrid Guerra Azevedo
- Department of Physiotherapy, Federal University of Rio Grande do Norte, Lagoa Nova, Natal, RN Brazil.,Empresa Brasileira de Serviços Hospitalares, University Hospital Ana Bezerra, Santa Cruz, Brazil
| | - Silvana Loana De Oliveira Sousa
- Departamento de Patología y Cirugía (Grado en Fisioterapia), Universidad Miguel de Hernández, Facultad de Medicina, Murcia, Spain
| | | | - Diego De Sousa Dantas
- Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, RN Brazil
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Dufour S, Hondronicols A, Flanigan K. Enhancing Pelvic Health: Optimizing the Services Provided by Primary Health Care Teams in Ontario by Integrating Physiotherapists. Physiother Can 2019; 71:168-175. [PMID: 31040512 DOI: 10.3138/ptc.2017-81.pc] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: The purpose of this review was threefold: (1) to outline the current landscape of service provision for two common pelvic floor disorders, urinary incontinence (UI) and pelvic organ prolapse (POP); (2) to describe common pelvic floor dysfunctions (UI and POP) and the associated evidence-based, conservative care; and (3) to present the potential to integrate physiotherapists into inter-professional primary health care teams to optimize the provision of care for these disorders. Method: A literature review was undertaken and a case study was developed to describe evidence-informed conservative care for pelvic floor dysfunctions. Results: A variety of models exist to treat pelvic floor disorders. Physiotherapists and nurses are key care providers, and their scope and care provision overlaps. In Ontario specifically, both nurses and physiotherapists with additional postgraduate training in pelvic floor disorders are integrated into primary health care, but only to a very limited degree, and they are arguably well positioned to leverage their skills in their respective scopes of practice to optimize the provision of pelvic health care. Conclusions: Physiotherapists and nurses are shown to be key providers of effective, conservative care to promote pelvic health. There is an opportunity to integrate these types of provider into primary care organizations in Ontario; this collaborative care could translate into improved outcomes for patients and the health care system at large.
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Affiliation(s)
- Sinéad Dufour
- School of Rehabilitation Science.,Faculty of Health Sciences, Department of Family Medicine, McMaster University.,The World of My Baby, Milton, Ont
| | - Amy Hondronicols
- School of Rehabilitation Science.,Hamilton Family Health Team, Hamilton, Ont
| | - Kathryn Flanigan
- Faculty of Health Sciences, Department of Family Medicine, McMaster University
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16
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Birthweight and pelvic floor trauma after vaginal childbirth. Int Urogynecol J 2019; 30:985-990. [DOI: 10.1007/s00192-019-03882-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 01/15/2019] [Indexed: 12/28/2022]
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17
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SCARABELOT KS, ANTUNES MMU, PELEGRINI A, VIRTUOSO JF. Pelvic, anorectal and urinary symptoms according to the nutritional status of adult women: A cross-sectional study. REV NUTR 2019. [DOI: 10.1590/1678-9865201932e180257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT To review the occurrence of pelvic, anorectal and urinary symptoms according to the nutritional status of adultwomen. Methods This is a cross-sectional study with 54 women, aged 18 to 35 years, divided into normal weight (<25kg/m2), overweight (25kg/m2 to 29.99kg/m2) and obesity (≥30kg/m2) according to the body mass index. The presence of pelvic floor muscle dysfunction symptoms was assessed by the Pelvic Floor Distress Inventory and the impact of these symptoms by the Pelvic Floor Impact Questionnaire. Descriptive and inferential statistics were used, with a significance level of 5%. Results Pelvic Floor Distress Inventory total score was 22.95 (SD=26.11) in the eutrophic group and 59.67 (SD=47.80) in the obesity group (p=0.01). Considering the scales, urinary symptoms were higher in obese women than in the eutrophic group (p=0.01). In the assessment of patients with each symptom, a difference (p<0.01) was observed in incomplete bowel emptying, in which the highest frequency occurred in overweight women (47.4%) compared to eutrophic and obese women (both 26.3%). Urinary incontinence symptoms (18.2% in eutrophic women, 27.3% overweight and 54.5% obese), stress urinary incontinence (8.3% eutrophic, 41.7% overweight and 50.0%, obese) and difficulty in emptying the bladder (0.0% eutrophic, 33.3% overweight and 66.7% obese) exhibited higher frequencies (p=0.03; p<0,01 and p=0.02, respectively) in obese women. Conclusion Symptoms of pelvic floor muscles dysfunction, especially urinary tract muscles, occur more frequently in obese adult women when compared to eutrophic women.
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Avcıbay Vurgeç B, Kızılkaya Beji N. İleri evre pelvik organ proplapsusu olan kadınlarda yaşam kalitesi ve cinsel yaşam. CUKUROVA MEDICAL JOURNAL 2018. [DOI: 10.17826/cumj.427253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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19
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Kremel D, Riss S, Müller C, von Strauss M, Winstanley C, Winstanley J, Potter M, Paterson H, Collie M. Adverse obstetric history is not a risk factor for poor outcome after ventral rectopexy for obstructive defaecation syndrome. Colorectal Dis 2018; 20:1125-1131. [PMID: 30171744 DOI: 10.1111/codi.14392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 07/02/2018] [Indexed: 12/13/2022]
Abstract
AIM Ventral rectopexy (VR) has gained popularity in the management of obstructive defaecation syndrome (ODS) due to a symptomatic rectocele ± intussusception. Data on the efficacy and safety of VR are variable and there are few predictors of successful outcome. This study aimed to examine whether or not an adverse obstetric history influenced the functional outcome following VR for ODS. METHOD This was a retrospective study of a cohort of 76 consecutive patients who had undergone VR for ODS at a tertiary referral centre between 2012 and 2015. Patients were followed up by telephone questionnaire. The obstetric history and pre- and postoperative symptoms of ODS and faecal incontinence (FI) were obtained from telephone interviews. RESULTS In this cohort, symptoms of ODS were significantly improved by surgery, with 56% of patients showing a reduction of symptoms of 50% or more (P < 0.001). Subgroup analysis demonstrated that a lower body mass index (BMI; 24.4 vs 27.3 kg/m2 ; P < 0.05) and shorter duration of symptoms (7 vs 10 years; P < 0.05) led to a better outcome. VR had no effect on FI. Obstetric factors such as foetal weight, instrumental delivery, episiotomy, perineal tear and total number of deliveries did not influence outcomes. CONCLUSION Patients with a less straightforward obstetric history can be reassured that this should not adversely influence the functional outcome after VR for ODS. Colorectal surgeons who offer this surgery should warn patients with an elevated BMI or with longstanding symptoms that the operation may be less successful than for those with a lower BMI or shorter duration of symptoms.
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Affiliation(s)
- D Kremel
- Department of Colorectal Surgery, Western General Hospital, Edinburgh, UK
| | - S Riss
- Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - C Müller
- Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - M von Strauss
- Department of Surgery, University Hospital Basel, Basel, Switzerland
| | - C Winstanley
- Department of Colorectal Surgery, Western General Hospital, Edinburgh, UK
| | - J Winstanley
- Department of Colorectal Surgery, Western General Hospital, Edinburgh, UK
| | - M Potter
- Department of Colorectal Surgery, Western General Hospital, Edinburgh, UK
| | - H Paterson
- Department of Colorectal Surgery, Western General Hospital, Edinburgh, UK
| | - M Collie
- Department of Colorectal Surgery, Western General Hospital, Edinburgh, UK
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Fekete Z, Kőrösi S, Pajor L, Bajory Z, Németh G, Kozinszky Z. Does anchoring vaginal mesh increase the potential for correcting stress incontinence? BMC Urol 2018; 18:53. [PMID: 29855312 PMCID: PMC5984302 DOI: 10.1186/s12894-018-0363-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 05/11/2018] [Indexed: 11/22/2022] Open
Abstract
Background This study aims to explore the feasibility of anchoring a four-arm transvaginal mesh (TVM) to the mid-urethra to correct an anterior compartment POP–Quantification stage II–III (Q II–III) and concomitant genuine SUI. Methods We analysed clinical data from 248 patients with stage II–III anterior prolapse and concomitant SUI who had undergone surgery at a tertiary referral centre in Hungary between January 2008 and June 2010. One hundred and twenty-four women treated with anterior colporrhaphy and 62 patients implanted with a conventional permanent TVM were selected as historical matched controls. Sixty-two patients received a modified permanent TVM, where the mesh was fixed to the mid-urethra with two stitches for the purpose of potentially correcting SUI. Surgical complications were classified using the Clavien–Dindo (CD) classification system. Results The anti-SUI efficacy was minimally higher in the mTVM group than in the original TVM group (p = 0.44, 96.8% vs 91.9%, respectively), while prosthesis surgery was more effective than anterior colporrhaphy in improving the anterior compartment POP–Q status (96.8, 90.3% vs 64.5%, respectively). Anchoring the mesh did not increase the extrusion rate (p = 0.11). The de novo urge symptoms were not more prevalent among those who had received additional periurethral stitches (p = 1.00, 11.3% vs 12.9%). The incidence of reoperation observed in the mTVM group was non-significantly lower than that in the TVM group (p = 0.15, 6.5% vs 16.1%); however, the difference did not reach the level of significance. The early postoperative complication profile was more favourable among the mTVM patients (classified as CD I: 8.1%; CD II: 1.6%; and CD IIIb: 1.6%) as compared to the TVM group (p = 0.013). Conclusions The new, modified mesh surgery represents an effective procedure for prolapse and concomitant SUI with a decreased risk of short- and long-term complications.
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Affiliation(s)
- Zoltán Fekete
- Department of Urology, University of Szeged, Hungary, Semmelweis u. 1, Szeged, H-6725, Hungary. .,Department of Obstetrics and Gynaecology, University of Szeged, Hungary, Semmelweis u. 1, Szeged, H-6725, Hungary.
| | - Szilvia Kőrösi
- Department of Obstetrics and Gynaecology, University of Szeged, Hungary, Semmelweis u. 1, Szeged, H-6725, Hungary
| | - László Pajor
- Department of Urology, University of Szeged, Hungary, Semmelweis u. 1, Szeged, H-6725, Hungary
| | - Zoltán Bajory
- Department of Urology, University of Szeged, Hungary, Semmelweis u. 1, Szeged, H-6725, Hungary
| | - Gábor Németh
- Department of Obstetrics and Gynaecology, University of Szeged, Hungary, Semmelweis u. 1, Szeged, H-6725, Hungary
| | - Zoltan Kozinszky
- Department of Obstetrics and Gynaecology, Blekinge Hospital, Karlskrona, Sweden
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Jaunarena JH, Kowalik CG, Delpe SD, Kaufman MR, Dmochowski RR, Stuart Reynolds W. Effects of Pelvic Organ Prolapse on the Bladder. CURRENT BLADDER DYSFUNCTION REPORTS 2018. [DOI: 10.1007/s11884-018-0473-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Gephart LF, Doersch KM, Reyes M, Kuehl TJ, Danford JM. Intraabdominal pressure in women during CrossFit exercises and the effect of age and parity. Proc (Bayl Univ Med Cent) 2018; 31:289-293. [PMID: 29904290 DOI: 10.1080/08998280.2018.1446888] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 01/19/2018] [Accepted: 01/22/2018] [Indexed: 10/17/2022] Open
Abstract
To determine intraabdominal pressure (IAP) in women during CrossFit and to determine whether parity, age, or CrossFit experience affects IAP during CrossFit exercises, we evaluated 10 women: 5 experienced and active CrossFitters and 5 who were not regularly engaged in CrossFit. A Laborie urodynamics abdominal pressure probe with the Goby wireless system measured IAP during 10 repetitions of 13 different CrossFit exercises. Women had a mean age of 36 years. A significant difference was found between mean peak IAP of the 5 parous vs the 5 nulliparous women (P = 0.009). Experience with CrossFit did not affect mean peak IAP achieved with exercise. In some exercises, there was a significant change in IAP as participants progressed through repetitions (P = 0.003 for back squats and 0.04 for sit-ups). Participants achieved IAP values that were markedly higher than those previously published.
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Affiliation(s)
- Laura Faye Gephart
- Department of Obstetrics and Gynecology, University of Texas, Rio Grande Valley, Rio Grande Valley, Texas
| | - Karen M Doersch
- Texas A&M Health Science Center College of Medicine, Temple, Texas
| | - Michelle Reyes
- Department of Research Administration, Scott & White Medical Center, Temple, Texas
| | - Thomas J Kuehl
- Department of Obstetrics and Gynecology, Scott & White Medical Center, Temple, Texas
| | - Jill M Danford
- Department of Obstetrics and Gynecology, Scott & White Medical Center, Temple, Texas
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Wang H, Ghoniem G. Postpartum stress urinary incontinence, is it related to vaginal delivery? J Matern Fetal Neonatal Med 2017; 30:1552-1555. [DOI: 10.1080/14767058.2016.1209648] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Hong Wang
- Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Affiliated Hospital of Capital Medical University, Beijing, China
- Department of Urology, University of California, Irvine, Orange, CA, USA
| | - Gamal Ghoniem
- Department of Urology, University of California, Irvine, Orange, CA, USA
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Edqvist M, Hildingsson I, Mollberg M, Lundgren I, Lindgren H. Midwives' Management during the Second Stage of Labor in Relation to Second-Degree Tears-An Experimental Study. Birth 2017; 44:86-94. [PMID: 27859542 PMCID: PMC5324579 DOI: 10.1111/birt.12267] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/02/2016] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Most women who give birth for the first time experience some form of perineal trauma. Second-degree tears contribute to long-term consequences for women and are a risk factor for occult anal sphincter injuries. The objective of this study was to evaluate a multifaceted midwifery intervention designed to reduce second-degree tears among primiparous women. METHODS An experimental cohort study where a multifaceted intervention consisting of 1) spontaneous pushing, 2) all birth positions with flexibility in the sacro-iliac joints, and 3) a two-step head-to-body delivery was compared with standard care. Crude and Adjusted OR (95% CI) were calculated between the intervention and the standard care group, for the various explanatory variables. RESULTS A total of 597 primiparous women participated in the study, 296 in the intervention group and 301 in the standard care group. The prevalence of second-degree tears was lower in the intervention group: [Adj. OR 0.53 (95% CI 0.33-0.84)]. A low prevalence of episiotomy was found in both groups (1.7 and 3.0%). The prevalence of epidural analgesia was 61.1 percent. Despite the high use of epidural analgesia, the midwives in the intervention group managed to use the intervention. CONCLUSION It is possible to reduce second-degree tears among primiparous women with the use of a multifaceted midwifery intervention without increasing the prevalence of episiotomy. Furthermore, the intervention is possible to employ in larger maternity wards with midwives caring for women with both low- and high-risk pregnancies.
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Affiliation(s)
- Malin Edqvist
- Institute of Health and Care SciencesThe Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Ingegerd Hildingsson
- Department of NursingMid Sweden UniversitySundsvallSweden,Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Margareta Mollberg
- Institute of Health and Care SciencesThe Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Ingela Lundgren
- Institute of Health and Care SciencesThe Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Helena Lindgren
- Institute of Health and Care SciencesThe Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Women's and Children's HealthKarolinska InstituteStockholmSweden
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Lee J, Lee K, Song C. Determining the Posture and Vibration Frequency that Maximize Pelvic Floor Muscle Activity During Whole-Body Vibration. Med Sci Monit 2016; 22:4030-4036. [PMID: 27787476 PMCID: PMC5087668 DOI: 10.12659/msm.898011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background The aim of this study was to investigate the electromyogram (EMG) response of pelvic floor muscle (PFM) to whole-body vibration (WBV) while using different body posture and vibration frequencies. Material/Methods Thirteen healthy adults (7 men, 6 women) voluntarily participated in this cross-sectional study in which EMG data from PFM were collected in a total of 12 trials for each subject (4 body postures, 3 vibration frequencies). Pelvic floor EMG activity was recorded using an anal probe. The rating of perceived exertion (RPE) was assessed with a modified Borg scale. Results We found that vibration frequency, body posture, and muscle stimulated had a significant effect on the EMG response. The PFM had high activation at 12 Hz and 26 Hz (p<0.05). PFM activation significantly increased with knee flexion (p<0.05). The RPE significantly increased with increased frequency (p<0.05). Conclusions The knee flexion angle of 40° at 12 Hz frequency can be readily promoted in improving muscle activation during WBV, and exercise would be performed effectively. Based on the results of the present investigation, sports trainers and physiotherapists may be able to optimize PFM training programs involving WBV.
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Affiliation(s)
- Juhyun Lee
- Department of Physical Therapy, College of Health Science, Sahmyook University, Seoul, South Korea
| | - Kyeongjin Lee
- Department of Physical Therapy, College of Health Science, Sahmyook University, Seoul, South Korea
| | - Changho Song
- Department of Physical Therapy, College of Health Science, Sahmyook University, Seoul, South Korea
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Amir B, Allen VM, Kirkland S, MacPherson K, Farrell S. The Long-Term Pelvic Floor Health Outcomes of Women After Childbirth: The Influence of Labour in the First Pregnancy. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2016; 38:827-838. [DOI: 10.1016/j.jogc.2016.03.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 03/30/2016] [Indexed: 01/30/2023]
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Lykke R, Blaakær J, Ottesen B, Gimbel H. Age at hysterectomy as a predictor for subsequent pelvic organ prolapse repair. Int Urogynecol J 2015; 27:751-5. [PMID: 26564221 DOI: 10.1007/s00192-015-2881-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 10/26/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The aim of this study was to investigate the association between patient age at the time of hysterectomy and subsequent pelvic organ prolapse (POP) surgery. METHODS We gathered data on all benign hysterectomies and POP surgeries performed in Denmark on Danish women from 1977 to 2009 from the Danish National Patient Registry. The cohort consisted of 154,882 hysterectomized women, who were followed up for up to 32 years. Survival analysis for each age group at hysterectomy was performed using Kaplan-Meier product limit methods. RESULTS For all hysterectomized women, we found that low age at hysterectomy yielded a lower risk of subsequent POP surgery than did hysterectomy at an older age. This difference diminished after stratification by indication; all non-POP hysterectomies had a low cumulative incidence at 8-11 % at the end of the follow-up period. For all women hysterectomized, the predominant compartment for POP surgery was the posterior. Women hysterectomized when aged over 66 years had a higher proportion of POP surgery in the apical compartment than in the other age groups (p = 0.000). CONCLUSION Our findings indicate that age at hysterectomy only marginally influences the risk of subsequent POP surgery for women hysterectomized for indications other than POP. If POP is the indication for hysterectomy, the risk of undergoing subsequent POP surgery increases substantially.
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Affiliation(s)
- Rune Lykke
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark. .,Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
| | - Jan Blaakær
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Bent Ottesen
- Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark
| | - Helga Gimbel
- Department of Obstetrics and Gynecology, Nykøbing Falster Hospital, Nykøbing Falster, Denmark
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