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Saltiel F, Miranda-Gazzola APG, Vieira GF, Figueiredo EM. Advancing women's pelvic floor muscle function diagnosis: the EFSMAP examination and its reliability evaluation. Braz J Phys Ther 2024; 28:101067. [PMID: 38815549 PMCID: PMC11166699 DOI: 10.1016/j.bjpt.2024.101067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/20/2023] [Accepted: 04/22/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND The accurate diagnosis of pelvic floor muscle impairments is essential. The plethora of terms and the lack of evidence to support widely used pelvic floor muscle function (PFMF) measurements hinder diagnostic labels. OBJECTIVE To structure an examination of PFMF using visual observation and digital palpation and terms consistent with the ICF terminology, and to test its intra and interrater reliability/agreement. METHODS A panel of 9 physical therapists applied Delphi method to structure the PFMF exam under ICF terminology and to verify its measurements reproducibility. For reliability and agreement, a convenience sample of women aged 51.2 ± 14.7 years had the sensitivity to pressure, pain, muscle tone, involuntary movement reaction, control of voluntary movement (contraction/relaxation), coordination, strength, and endurance examined by two raters, in the same day for interrater (n = 40), and one week apart, for intrarater reliability (n = 25). Percent agreement, linear weighted kappa, intraclass correlation coefficient, and Bland-Altman's limits of agreement were calculated (alpha = 0.05). RESULTS Four round Delphi discussion structured the PFMF exam, named EFSMAP (Exame das Funções Sensoriais e Motoras do Assoalho Pélvico/Examination of Pelvic Floor Sensory and Motor Functions), set a list of concepts and instructions targeted at reproducibility and established PFMF diagnostic labels. Reliability, except for pain and tone, were moderate to excellent (Kw= 0.67-1.0 and ICC=0.48-0.82). Agreement was substantial for most PFMF features (0.64-1.00), except pain. CONCLUSIONS The EFSMAP was successfully developed as a valid and reliable exam to be used in research and clinical practice; it provides labels for the diagnosis of pelvic floor muscle impairments. It might be easily adopted worldwide as it uses ICF terminology.
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Affiliation(s)
- Fernanda Saltiel
- Rehabilitation Sciences Program, Universidade Federal de Minas Gerais, Brazil. (UFMG), Belo Horizonte, MG, Brazil; Faculdade de Ciências Médicas de Minas Gerais (FCMMG), Belo Horizonte, MG, Brazil
| | | | - Gabriella Ferreira Vieira
- Rehabilitation Sciences Program, Universidade Federal de Minas Gerais, Brazil. (UFMG), Belo Horizonte, MG, Brazil
| | - Elyonara Mello Figueiredo
- Physical Therapy Department, Rehabilitation Sciences Program, Universidade Federal de Minas Gerais, Brazil (UFMG), Belo Horizonte, MG, Brazil.
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Deinstadt RTM, Sternin S, Reissing ED. Urinary Symptoms and their Impact on Young Women's Sexual Function and Quality of Life. JOURNAL OF SEX & MARITAL THERAPY 2023; 49:917-931. [PMID: 37317557 DOI: 10.1080/0092623x.2023.2222728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Sexuality and urinary function have received scarce research attention in younger women. In this cross-sectional survey study, prevalence, type, severity, and impact of urinary incontinence (UI), and its relationship with sexuality was investigated in 261 nulliparous women aged 18-27 (M = 19.08 years). Modules of the International Consultation on Incontinence Questionnaire and the Female Sexual Function Index assessed UI, sexual function, and quality of life. Thirty percent of the sample experienced UI, and 26% reported sexual function problems. A significant small negative correlation was found between UI and sexual lubrication (p = .017). Forty-three percent of participants in the total sample reported that they were bothered by urinary symptoms, and 13% avoided sexual activity due to urinary symptoms. Of those classified as incontinent, 90% were bothered by their symptoms. Urinary symptoms are impactful on the quality of life and sexual lives of young women, but despite their high prevalence, they remain a largely understudied and undertreated issue in this age group. Further research is crucial for improving awareness and access to treatment for this underserved population.
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Affiliation(s)
| | - Shulamit Sternin
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Elke D Reissing
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
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Li G, Yu P, Zhang F, Xu Y, Zhou G, Zhan X, Gao Y, Du X, Liu H, He R. The impact of the COVID-19 pandemic-related quarantine on female sexual behavior: a cross-sectional study in China. Sci Rep 2022; 12:19421. [PMID: 36371533 PMCID: PMC9653494 DOI: 10.1038/s41598-022-23974-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022] Open
Abstract
To investigate the impact and factors of home quarantine life on women's sexual lives and behaviors in different areas of China and analyze the prevalence of female sexual dysfunction (FSD) during the COVID-19 pandemic. We surveyed adult women who had a regular sexual life (including regular masturbation) and had been isolated at home for at least one month during the COVID-19 outbreak using online questionnaires. This survey recovered 678 complete questionnaires after screening. According to the findings, the overall score of the Female Sexual Function Inventory (FSFI) during the pandemic was 21.98 ± 6.38, the frequency of FSD was 61.9%, and the frequencies of FSD in Shanghai, Nanjing, and Ningxia were 60.6%, 75.2%, and 52.2%, respectively. The frequency of FSFI scores and other specific items (Desire, Arousal, Lubrication, Orgasm, Satisfaction, and Pain) varied significantly across the three regions (P < 0.05). The overall frequency of FSD in the masturbation population was 34.4%, which was lower than the frequency of FSD in women having paired sexual intercourse (60.1%) (p < 0.05). Further analysis revealed that the occurrence of FSD during the pandemic was related to different age stages, menopause, mode of delivery, level of anxiety and depression, and sexual lifestyles. The COVID-19 pandemic has had a great impact on people's spiritual and sexual lives, which are caused by multiple different variables related to both the individual and the environment. We should emphasize the importance of sexual health in epidemics, and having a harmonious and stable sex life will help us survive the boring life of isolation.
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Affiliation(s)
- Guangyong Li
- grid.412194.b0000 0004 1761 9803The General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, 750000 China
| | - Puguang Yu
- grid.412194.b0000 0004 1761 9803The General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, 750000 China
| | - Fen Zhang
- grid.412194.b0000 0004 1761 9803The General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, 750000 China
| | - Yanlong Xu
- grid.8547.e0000 0001 0125 2443Jinshan Hospital of Fudan University, Fudan University, Shanghai, 201500 China
| | - Gaiyan Zhou
- grid.89957.3a0000 0000 9255 8984The Affiliated Brain Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China
| | - Xuekang Zhan
- grid.412194.b0000 0004 1761 9803The General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, 750000 China
| | - Yu Gao
- grid.412194.b0000 0004 1761 9803The General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, 750000 China
| | - Xiaoli Du
- grid.412194.b0000 0004 1761 9803The General Hospital of Ningxia Medical University, Ningxia Medical University, Yinchuan, 750000 China
| | - Hetao Liu
- grid.412194.b0000 0004 1761 9803Key Laboratory of Fertility Preservation and Maintenance of Ministry of Education, Ningxia Medical University, Yinchuan, 750004 China
| | - Rui He
- grid.412194.b0000 0004 1761 9803Key Laboratory of Fertility Preservation and Maintenance of Ministry of Education, Ningxia Medical University, Yinchuan, 750004 China
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The association between amateur running with varying degrees of effort and sexual function among women. Int Urogynecol J 2022; 33:1659-1665. [PMID: 35412070 DOI: 10.1007/s00192-022-05197-3] [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: 02/01/2022] [Accepted: 03/22/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Sports and physical activity are known risk factors for altered pelvic floor function, which may affect sexual activity. The aim of this study was to examine the impact of amateur running on sexual function. METHODS Amateur runners were contacted through social media. Their pelvic floor dysfunction (PFD), sexual function and quality of life were evaluated by self-reported validated questionnaires (PFDI-20, PISQ-12, IIQ-7). They were divided by degrees of effort into 'High effort' and 'Moderate effort.' The differences between the two groups were examined by Mann-Whitney U, t and chi-square tests. RESULTS One hundred eighty amateur runners were included. No significant differences in the sexual function were found between the two groups. The 'High effort' group reported experiencing higher intensity orgasms compared with women in the 'Moderate effort' group, and a correlation was found between the weekly running distance and intensity of orgasm that they experienced (p = 0.004). CONCLUSIONS High effort physical activity may be associated with improved orgasm, which may be explained by better clitoral circulation and better function of the pelvic floor muscles. Clinicians that treat symptoms related to PFD and sexual dysfunction may raise awareness of the advantages of physical activity and pelvic floor muscle training and rehabilitation, which may improve tone and circulation and hence sexual function.
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ELmazny A, Salama S, Hussein M, Elsebaie EH, Magdy R. Female sexual dysfunction in newly diagnosed egyptian patients with neuromyelitis optica spectrum disorder. BMC Neurol 2022; 22:117. [PMID: 35331161 PMCID: PMC8943970 DOI: 10.1186/s12883-022-02648-8] [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: 01/14/2022] [Accepted: 03/14/2022] [Indexed: 11/22/2022] Open
Abstract
Background Few research works have explored female sexual dysfunction (FSD) in patients with Neuromyelitis optica spectrum disorder (NMOSD) which remains an ignored disease symptom. This work aimed to describe the frequency, patterns, and predictors of FSD in a sample of newly diagnosed AQP4-ab seropositive NMOSD patients. Methods This case-control study was conducted on 28 seropositive NMOSD patients and 31 age matched healthy controls. All included patients were asked to privately fill and hand back the following questionnaires: female sexual function index questionnaire (FSFI), Beck depression inventory II (BDI) and fatigue severity scale (FSS). Also, Modified Modified Ashworth scale (MMAS) and Expanded disability status scale (EDSS) were applied to all included patients. Results NMOSD patients had significantly lower total FSFI scores and significantly higher BDI and FSS scores than controls (P < 0.001). FSS scores were negatively correlated with total scores of FSFI as well as desire, lubrication, orgasm, and satisfaction scores. BDI scores was negatively correlated with desire and orgasm scores. The uncorrected visual FS score was negatively correlated with lower total scores of FSFI as well as arousal, orgasm, and satisfaction scores. The pain score was negatively correlated with the scores of the MMAS. The only predictors of FSFI total score were fatigue and visual disability. Visual disability was also a predictor of dysfunction in arousal and satisfaction domains, whereas spasticity in the lower limbs predicted sexual related pain. Conclusions Sexual dysfunction in patients with NMOSD is strongly related to fatigue, depression, visual disability, and lower limbs spasticity.
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Affiliation(s)
- Alaa ELmazny
- Department of Neurology, Faculty of Medicine, Cairo University, Cairo, Egypt.,Internal Medicine Department, Arabian Gulf University, Manama, Bahrain
| | - Sara Salama
- Department of Neurology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Mona Hussein
- Department of Neurology, Faculty of Medicine, Beni-Suef University, Salah Salem Street, Beni-Suef, 62511, Egypt.
| | - Eman Hany Elsebaie
- Public health and community medicine department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rehab Magdy
- Department of Neurology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Frederice CP, de Mira TAA, Machado HC, Brito LGO, Juliato CRT. Effect of Vaginal Stretching and Photobiomodulation Therapy on Sexual Function in Women with Pelvic Floor Myofascial Pain - A Randomized Clinical Trial. J Sex Med 2022; 19:98-105. [PMID: 34955173 DOI: 10.1016/j.jsxm.2021.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 10/03/2021] [Accepted: 10/17/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Spasm or increased tonus of the pelvic floor muscles (PFM) can cause myofascial pain (MP), which may result in painful intercourse and sexual dysfunction. AIM The effect of vaginal stretching (VS) with photobiomodulation therapy (PBMT) is compared to VS with sham PBMT in overall sexual function, rate and severity of painful intercourse at baseline and after treatment in women with pelvic floor MP. METHODS A double-blind randomized clinical trial of 103 women with MP: 1 group received 10 sessions of VS with PBMT (4 Joules of near-infrared light-808 nm at 3 points), and the other group received VS with sham PBMT. OUTCOMES Impact of treatment was measured by the number of women experiencing painful intercourse, Pain severity was measured by Visual Analog Scale and sexual function was assessed by the FSFI questionnaire. Variables were assessed at baseline and after ten sessions in the intervention groups. RESULTS After treatment, the number of women experiencing painful intercourse was significantly lower in both the VS with PBMT group (90.2-55%, P = .001), and VS with sham PBMT group (86.6-46.2%, P < .001). There was a significant reduction in pain measure by Visual Analog Scale (P < .001, [VS with PBMT group: P = .002; VS with sham PBMT group: P < .001]). There was a significant decrease in the number of participants with sexual dysfunction (FSFI score ≤26.55) after the treatment in the VS with PBMT group (92.2-74.5%, P = .003) and in the VS with sham PBMT group (90.4-76.9%, P = .035). Both groups showed improvement in the FSFI pain domain after treatment (P < .001, [VS with PBMT group: P = .038; VS with sham PBMT group: P = .005]). Only the VS with sham PBMT group had a significant increase in FSFI desire and total score (P < .001) after treatment. CLINICAL IMPLICATIONS We found that VS associated or not with PBMT may be effective in reducing complaints of painful intercourse, alleviating pain severity, and reducing the number of women with pelvic floor MP suffering from sexual dysfunction. STRENGTHS & LIMITATIONS Strengths of this study are the randomized design and use of validated questionnaires. Limitation of the study is the lack of a long follow-up period and the lack of a usual care comparison group hampers generalizability of the results. CONCLUSION VS only and VS with PBMT have short-term efficacy in reducing painful intercourse and reducing a number of women with sexual dysfunction.
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Affiliation(s)
- Claudia Pignatti Frederice
- Department of Gynecology and Obstetrics, School of Medical Science, University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Helymar Costa Machado
- Statistics Service, Department of Obstetrics and Gynecology, School of Medical Science, University of Campinas (UNICAMP), Campinas, Brazil
| | - Luiz Gustavo Oliveira Brito
- Department of Obstetrics and Gynecology, School of Medical Science, University of Campinas (UNICAMP), Campinas, Brazil
| | - Cássia R T Juliato
- Department of Obstetrics and Gynecology, School of Medical Science, University of Campinas (UNICAMP), Campinas, Brazil
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Decreased Sexual Desire among Middle-Aged and Old Women in China and Factors Influencing It: A Questionnaire-Based Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:6649242. [PMID: 34122604 PMCID: PMC8169273 DOI: 10.1155/2021/6649242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/30/2021] [Indexed: 12/11/2022]
Abstract
Objective This survey was designed and conducted with an aim to present data on sexual desire and activity in Chinese women. Methods Between October 2013 and December 2013, we surveyed 3000 women (aged 40–65 years) at Beijing No. 2 Hospital and the Yuetan Community Health Service Center using a questionnaire. The primary outcomes included determination of sexual desire in the past 4 weeks, reasons for stopping sexual activity, and postmenopausal syndrome. The secondary outcome was determination of factors for low sexual desire. Results A total of 2400 women (mean age 54.33 ± 6.25 years; mean menopausal age 50.11 ± 3.31 years) returned the questionnaire, with 58% of women reporting lowered sexual desire and 39.3% reporting stoppage of sexual activity. Compared with the postmenopausal group, the incidence of anxiety, depressive, somatic, and vasomotor symptoms was higher in the perimenopausal group. Muscle and joint pain (45.8%) and vaginal pruritus (21.5%) were the most commonly reported menopausal and vulvovaginal symptoms, respectively. The odds of decrease in sexual desire were significantly higher with older age, menopause, presence of gynecological disease, menopausal depression symptoms, menopausal vasomotor symptoms, and vulvovaginal atrophy; only cesarean delivery (odds ratio = 0.887, P=0.018) was associated with lesser reduction in sexual desire compared with the aforementioned factors. Conclusion This survey showed that a high proportion of Chinese middle-aged and old women have lowered sexual desire and activity. Lack of sexual desire is associated with multiple factors and affects the quality of life of women.
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Cetin SY, Buyuk A, Ayan A. Investigation of the relationship between the pelvic floor and sexual dysfunction in women with Sjögren's syndrome. Int J Rheum Dis 2020; 23:1728-1733. [PMID: 33068320 DOI: 10.1111/1756-185x.13998] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/14/2020] [Accepted: 09/21/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIM Women with Sjögren's syndrome (SS) may have sexual dysfunctions due to vaginal dryness and may also have pelvic floor problems. The aim of this study was to examine the pelvic floor distress of women with SS with a self-reported questionnaire, to compare this group with healthy individuals, and to examine the relationship between pelvic floor problems and sexual dysfunction. METHODS The study included 94 women with SS, aged 47.26 ± 7.56 years, and 94 age-matched healthy women, aged 48.15 ± 8.73 years. The Pelvic Floor Disease Inventory (PFDI-20), Pelvic Floor Impact Questionnaire (PFIQ-7), and Female Sexual Function Scale (FSFI) were used for assessment. RESULTS The PFDI-20, PFIQ-7, and FSFI scores of the healthy control group were found to be statistically significantly better than those of the primary SS group (Z = -2.69 to -8.03, P = .00). A moderate-high correlation was found between the total and sub-parameters of PFDI-20 and disease duration, the total and sub-parameters of the PFIQ-7 and the pain sub-parameter and total score of the FSFI (r = -0.66 to 0.78, P = .00-.04). CONCLUSION According to the study results, as the disease duration increases, the distress increases and this distress has a negative effect on the health-related quality of life of these women. Pelvic floor distress was associated with poor sexual function and pain. From these results, it can be recommended that the methods of pharmacology, education, exercise, relaxation, lifestyle change, and so on for pelvic floor dysfunction and pain in women with SS should be applied together with a multidisciplinary approach.
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Affiliation(s)
- Sebahat Yaprak Cetin
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Akdeniz University, Antalya, Turkey
| | - Alime Buyuk
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Akdeniz University, Antalya, Turkey
| | - Ayse Ayan
- Department of Rheumatology, Antalya Education and Research Hospital, Antalya, Turkey
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Ghizzani A, Luisi S, Cartocci A, Cevenini G. Genitopelvic pain: retrospective evaluation of a multimodal treatment efficacy. ACTA ACUST UNITED AC 2020; 72:123-131. [PMID: 33000613 DOI: 10.23736/s0026-4784.20.04555-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Genitopelvic and sexual pain penetration disorder (GPPD) recognizes a multifaceted etiology. As with syndromes of chronic pain, it responds poorly to medications and its management is difficult. Clinicians consequently favor a multimodal comprehensive approach to tackle the different aspects of the disorder. To treat GPPD women, we chose a multimodal regimen including topical and systemic medications associated with physical interventions and behavioral couple therapy. Our aim was to evaluate the regimen efficacy and the influence that demographic, clinical, and pain characteristics may have on the outcome. METHODS Sixty self -referred women requesting medical care for GPPD, who were free of debilitating illness, in stable heterosexual relationships and with healthy and sexually functional partners, were treated according with the multimodal regimen we tailored on the specific needs of these women. As said, it associated topical and systemic medications combined with physical exercises used in behavioral sex therapy, and behavioral couple therapy. Past sexual history, characteristics of pain, vestibular hyperreactivity, pelvic floor hypertonicity, general health, and couple harmony were evaluated and statistically analyzed to determine which characteristics were associated with therapy outcome. RESULTS The statistical analysis of an association between demographic, reproductive, pain and medical conditions on one hand and therapy outcome on the other did not find any significance. CONCLUSIONS The lack of association between the investigated characteristics and treatment outcome is disappointing; on the other hand, the statistically significant impact of couple harmony (evaluated as partner presence and participation) on the treatment results may be the answer to our search for factors predicting outcome.
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Affiliation(s)
- Anna Ghizzani
- Department of Molecular and Developmental Medicine, Obstetrics and Ginecology, University of Siena, Siena, Italy
| | - Stefano Luisi
- Department of Molecular and Developmental Medicine, Obstetrics and Ginecology, University of Siena, Siena, Italy -
| | | | - Gabriele Cevenini
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
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Marques Cerentini T, La Rosa VL, Goulart CDL, Latorre GFS, Caruso S, Sudbrack AC. Female sexual dysfunctions: prevalence and related factors in a sample of young university women – a cross-sectional study. SEXUAL AND RELATIONSHIP THERAPY 2020. [DOI: 10.1080/14681994.2020.1748592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | | | | | | | - Salvatore Caruso
- Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic, Research Group for Sexology, University of Catania, Catania, Italy
| | - Ana Cristina Sudbrack
- Physiotherapy Department, University of Santa Cruz do Sul – UNISC, Santa Cruz do Sul, RS, Brazil
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de Carvalho Fusco HCS, Filho MAP, Consolo RT, Lunardi AC, Ferreira EAG. Sexual performance and pelvic floor muscle strength in patients with fibromyalgia: a controlled cross-sectional study. Rheumatol Int 2020; 41:415-421. [PMID: 32377958 DOI: 10.1007/s00296-020-04595-4] [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: 02/11/2020] [Accepted: 04/24/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Fibromyalgia (FM) is characterized by chronic and widespread pain, sleep disturbances, fatigue, psychological distress and morning stiffness. These patients also present symptoms such as depression, sexual dysfunctions and reproductive problems. Sexuality involves several aspects, including pelvic floor functionality, and one question is whether the sexual performance of women with fibromyalgia is associated with pelvic floor function or other characteristics of the disease. OBJECTIVE The aim of this study was to gauge the association between perineal function and sexual performance in women with and without fibromyalgia. METHODS We performed a cross-sectional study with 109 sexually active women from 19 to 65 years of age, either suffering from fibromyalgia (FM group, n = 51) or free from fibromyalgia (non-FM group, n = 58). Perineal function was measured with the use of perineometry and digital vaginal palpation (PERFECT Scheme), while sexual performance was assessed by the Sexual Quotient Female questionnaire (QS-F). RESULTS Patients with fibromyalgia presented poor sexual performance compared to those without fibromyalgia (QS-F score 58 (32-66) vs. 66 (56-70); p = 0.002) as well as lower pelvic floor muscle strength measured by perineometry (32.5 (18.2-40.5) vs. 37.9 (23.4- 57.3); p = 0.03). Patients without fibromyalgia presented a positive correlation between perineometry and QS-F (r = 0.22; p = 0.038), while those with fibromyalgia presented no correlation between those two variables (r = 0.22; p = 0.12). The regression model showed an association between sexual performance and the presence of fibromyalgia, pelvic floor muscle strength (perineometry) and age, according to the following equation: sexual performance = 48.52 + (9.5 * non-FM group) + (0.23 * perineometry)-(0.4 * age), with adjusted R2 = 0.19. CONCLUSION Women with FM present poor sexual performance and lower pelvic floor muscle strength compared to those without FM. However, the correlation between these variables among women without FM was not observed in women with FM. Sexual performance showed a positive association with absence of fibromyalgia and higher pelvic floor muscle strength, and a negative association with age.
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Affiliation(s)
- Hellen Cristina Souza de Carvalho Fusco
- Department of Physiotherapy, Speech Therapy and Occupational Therapy, School of Medicine, Faculty of Medicine, University of São Paulo, Cipotanea Street, 51, São Paulo, SP, Brazil.
| | - Marco Antônio Pontes Filho
- Department of Rheumatology, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Rafael Treitero Consolo
- Department of Physiotherapy, Speech Therapy and Occupational Therapy, School of Medicine, Faculty of Medicine, University of São Paulo, Cipotanea Street, 51, São Paulo, SP, Brazil
| | - Adriana Claudia Lunardi
- Department of Physiotherapy, Speech Therapy and Occupational Therapy, School of Medicine, Faculty of Medicine, University of São Paulo, Cipotanea Street, 51, São Paulo, SP, Brazil
| | - Elizabeth Alves Gonçalves Ferreira
- Department of Physiotherapy, Speech Therapy and Occupational Therapy, School of Medicine, Faculty of Medicine, University of São Paulo, Cipotanea Street, 51, São Paulo, SP, Brazil
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Abstract
Vulvodynia is a condition that occurs in 8-10% of women of all ages and is characterized by pain at the vulva that is present during sexual and/or non-sexual situations. Diagnosis is established through careful medical history and pelvic examination, including the cotton-swab test. The onset and maintenance of vulvodynia involves a complex interplay of peripheral and central pain mechanisms, pelvic floor muscle and autonomic dysfunction, anxiety, depression and childhood maltreatment as well as cognitive-affective, behavioural and interpersonal factors. Given the absence of empirically supported treatment guidelines, a stepwise approach of pelvic floor physical therapy and cognitive behavioural therapy as well as medical management is suggested, with surgery as the last option. Vulvodynia has a negative effect on the quality of life of women and their partners, and imposes a profound personal and societal economic burden. In addition, women with vulvodynia are more likely to report other chronic pain conditions, which further alters their quality of life. Future efforts should aim to increase girls', women's and healthcare professionals' education and awareness of vulvodynia, phenotype different subgroups of women based on biopsychosocial characteristics among more diverse samples, conduct longitudinal studies and improve clinical trial designs.
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Sánchez-Sánchez B, Navarro-Brazález B, Arranz-Martín B, Sánchez-Méndez Ó, de la Rosa-Díaz I, Torres-Lacomba M. The Female Sexual Function Index: Transculturally Adaptation and Psychometric Validation in Spanish Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030994. [PMID: 32033334 PMCID: PMC7037847 DOI: 10.3390/ijerph17030994] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 01/30/2020] [Accepted: 02/02/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND The evaluation of sexual function is an important outcome in women who suffer some pelvic floor disorders (PFD). The Female Sexual Function Index (FSFI) is the most widely used questionnaire to evaluate the sexual health in female population. This study presents the adaptation and psychometric validation of the FSFI for Spanish women with PFD. METHODS The Spanish version of the FSFI was developed through the forward and backward translation process. The psychometric properties of reliability, validity, responsiveness, and feasibility were conducted in Spanish women with PFD who were assigned to the case or control group (with or without sexual dysfunction respectively). RESULTS A total of 323 Spanish women with PFD were recruited. The cross-cultural adaptation of the Spanish FSFI achieved a good semantic, conceptual, idiomatic, and content equivalence. The test-retest reliability was shown to be high in all of the cases. The convergent validity showed high results in the domain intercorrelations between each domain and total FSFI. The discriminant validity showed statistically significant differences between sexual dysfunction and control groups. The responsiveness was shown to be moderate to good in the dimensions and excellent in the total FSFI. CONCLUSIONS Spanish FSFI can be used as a reliable, valid, responsive, and feasible instrument for assessing sexual function in women.
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A review of the effect of faecal incontinence and constipation on sexual function. Int J Colorectal Dis 2019; 34:387-391. [PMID: 30635719 DOI: 10.1007/s00384-018-03231-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/27/2018] [Indexed: 02/04/2023]
Abstract
AIM Faecal incontinence and constipation are common conditions which may adversely affect quality of life. They may have an adverse effect on sexual function. METHOD This review of the published literature aimed to assess the published evidence. RESULTS Only seven published studies have reported the effect of these conditions on sexual function. Four reported on those with faecal incontinence. Two reported on those with faecal incontinence and constipation and one reported solely on constipation. All were questionnaire-based studies or retrospective reviews of institutional databases. A heterogenous mix of different measures of sexual function were applied. Conflicting findings were reported. Some studies suggested that those with faecal incontinence and constipation may have adverse sexual experiences. Others suggest that these pelvic floor disorders have no significant effect. CONCLUSION Further work is needed to investigate this. Large questionnaire studies with normal subject controls and adjustment for confounding factors are likely to be needed.
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15
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An international Urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for the assessment of sexual health of women with pelvic floor dysfunction. Int Urogynecol J 2018; 29:647-666. [DOI: 10.1007/s00192-018-3603-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 12/18/2017] [Indexed: 01/13/2023]
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16
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Rogers RG, Pauls RN, Thakar R, Morin M, Kuhn A, Petri E, Fatton B, Whitmore K, Kinsberg S, Lee J. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the assessment of sexual health of women with pelvic floor dysfunction. Neurourol Urodyn 2018; 37:1220-1240. [PMID: 29441607 DOI: 10.1002/nau.23508] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 12/18/2017] [Indexed: 12/18/2022]
Abstract
AIMS The terminology in current use for sexual function and dysfunction in women with pelvic floor disorders lacks uniformity, which leads to uncertainty, confusion, and unintended ambiguity. The terminology for the sexual health of women with pelvic floor dysfunction needs to be collated in a clinically-based consensus report. METHODS This report combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA), and the International Continence Society (ICS), assisted at intervals by many external referees. Internal and external review was developed to exhaustively examine each definition, with decision-making by collective opinion (consensus). Importantly, this report is not meant to replace, but rather complement current terminology used in other fields for female sexual health and to clarify terms specific to women with pelvic floor dysfunction. RESULTS A clinically based terminology report for sexual health in women with pelvic floor dysfunction encompassing over 100 separate definitions, has been developed. Key aims have been to make the terminology interpretable by practitioners, trainees, and researchers in female pelvic floor dysfunction. Interval review (5-10 years) is anticipated to keep the document updated and as widely acceptable as possible. CONCLUSION A consensus-based terminology report for female sexual health in women with pelvic floor dysfunction has been produced aimed at being a significant aid to clinical practice and a stimulus for research.
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Affiliation(s)
| | | | - Ranee Thakar
- Croydon University Hospital Croydon, London, United Kingdom
| | | | - Annette Kuhn
- University Teaching Hospital Berne (Inselspital), Bern, Switzerland
| | | | - Brigitte Fatton
- University Hospital Nîmes, Nimes, Languedoc-Roussillon, France
| | | | | | - Joseph Lee
- University of New South Wales, St Vincents Hospital, Sydney, New South Wales, Australia
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Han W, Wang Y, Qi S, Li T, Cao J, Zheng T, Su Y. Observation of the effect of physical rehabilitation therapy combined with the medication on pelvic floor dysfunction. Exp Ther Med 2017; 15:1211-1216. [PMID: 29399117 PMCID: PMC5774529 DOI: 10.3892/etm.2017.5583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 05/18/2017] [Indexed: 12/13/2022] Open
Abstract
We observed the effects of physical rehabilitation therapy combined with medication on pelvic floor dysfunction (PFD). We collected the medical records of 84 maternal patients with PFD who received treatment at the Affiliated Hospital of Hebei University between May 2015 and October 2016. These patients were randomly divided into two groups, the control group (n=42) and observation group (n=42). In the control group, patients received conventional physical rehabilitation therapy while in observation group, patients received the shixiao powder combined with siwu decoction in addition to the physical rehabilitation. The therapeutic effects were compared between the two groups. The total effective rate of the observation group was 97.6%, which was significantly higher than 78.6% in the control group (P<0.05). In observation group, the index scores of pelvic floor function under rest state, such as electromyo-graphy amplitude, contraction force, coordinate strength and urine flow rate, were significantly higher than those in control group (P<0.05). The rate of Grade II perineal muscle strength in the observation group was 7.32%, which was significantly lower than 47.62% in control group (P<0.05). In observation group, the rates of Grade III and Grade IV muscle strength were respectively 43.91 and 29.26%, which were significantly higher than those in control group (P<0.05). Before the administration of treatment, there were no significant differences in the comparison of the urinary incontinence and sexual life quality of patients between the two groups (P>0.05). In observation group, after treatment, the rehabilitation effects of urinary incontinence and sexual life quality at 3 months post-delivery were significantly better than those in control group (P<0.05). Before treatment, there were no significant differences in the comparison of levels of C-reactive protein (CRP) and interleukin-10 (IL-10) between the two groups (P>0.05), however, after treatment, the levels of CRP and IL-10 of patients in observation group were significantly lower than those in control group (P<0.05). In the observation group, the incidence rate of complications (7.14%) were significantly lower than that in control group (23.81%; P<0.05). Therefore, physical rehabilitation therapy combined with the shixiao powder and siwu decoction exhibits significant efficacy in the treatment of PFD by effectively improving the pelvic floor functions, increasing perineal muscle strength, and decreasing expression levels of inflammatory factors, which can significantly ameliorate life quality and reduce the incidence rate of complications. Thus, this treatment method shows great application value in clinical practice.
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Affiliation(s)
- Wei Han
- Maternity and Child Care Among Perinatal Care Clinic, Tangshan, Hebei 063000, P.R. China
| | - Yongmei Wang
- Department of Gynecology and Obstetrics, The Fourth Hospital of Hebei Medical University (Tumor Hospital of Hebei) Shijiazhuang, Hebei 050011, P.R. China
| | - Shengbo Qi
- Hospital of Gastrointestinal Surgery, Weifang, Shandong 261042, P.R. China
| | - Tingting Li
- Department of Thoracic Surgery, Affiliated Hospital of Hebei University, Baoding, Hebei 071000, P.R. China
| | - Jiang Cao
- Hospital of Gastrointestinal Surgery, Weifang, Shandong 261042, P.R. China
| | - Tinghua Zheng
- Maternity and Child Care Department of Obstetrics and Gynecology, Tangshan, Hebei 063000, P.R. China
| | - Yan Su
- Maternal and Child Health Care Medicine, Tangshan, Hebei 063000, P.R. China
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Riemsma R, Hagen S, Kirschner-Hermanns R, Norton C, Wijk H, Andersson KE, Chapple C, Spinks J, Wagg A, Hutt E, Misso K, Deshpande S, Kleijnen J, Milsom I. Can incontinence be cured? A systematic review of cure rates. BMC Med 2017; 15:63. [PMID: 28335792 PMCID: PMC5364653 DOI: 10.1186/s12916-017-0828-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 02/23/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Incontinence constitutes a major health problem affecting millions of people worldwide. The present study aims to assess cure rates from treating urinary (UI) or fecal incontinence (FI) and the number of people who may remain dependent on containment strategies. METHODS Medline, Embase, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, and PEDro were searched from January 2005 to June 2015. Supplementary searches included conference abstracts and trials registers (2013-2015). Included studies had patients ≥ 18 years with UI or FI, reported treatment cure or success rates, had ≥ 50 patients treated with any intervention recognized in international guideline algorithms, a follow-up ≥ 3 months, and were published from 2005 onwards. Title and abstract screening, full paper screening, data extraction and risk-of-bias assessment were performed independently by two reviewers. Disagreements were resolved through discussion or referral to a third reviewer where necessary. A narrative summary of included studies is presented. RESULTS Most evidence was found for UI: Surgical interventions for stress UI showed a median cure rate of 82.3% (interquartile range (IQR), 72-89.5%); people with urgency UI were mostly treated using medications (median cure rate for antimuscarinics = 49%; IQR, 35.6-58%). Pelvic floor muscle training and bulking agents showed lower cure rates for UI. Sacral neuromodulation for FI had a median cure rate of 38.6% (IQR, 35.6-40.6%). CONCLUSIONS Many individuals were not cured and hence may continue to rely on containment. No studies were found assessing success of containment strategies. There was a lack of data in the disabled and in those with neurological diseases, in the elderly and those with cognitive impairment. Surgical interventions were effective for stress UI. Other interventions for UI and FI showed lower cure rates. Many individuals are likely to be reliant on containment strategies. PROSPERO REGISTRATION PROSPERO registration number: CRD42015023763 .
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Affiliation(s)
- Rob Riemsma
- Kleijnen Systematic Reviews Ltd, Unit 6, Escrick Business Park, Riccall Road, Escrick, York, YO19 6FD, UK.
| | - Suzanne Hagen
- NMAHP Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Ruth Kirschner-Hermanns
- Neuro-Urologie, Clinic of Urology, University Clinic Friedrich-Wilhelms-University Bonn and Neurologic Rehabilitation Center Godeshoehe, Bonn, Germany
| | - Christine Norton
- Florence Nightingale Faculty of Nursing and Midwifery King's College London, London, UK
| | - Helle Wijk
- Centre for Person-Centred Care (GPCC), Institution for Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Christopher Chapple
- Department of Urology, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield, UK
| | | | - Adrian Wagg
- Division of Geriatric Medicine, University of Alberta, Edmonton, Canada
| | | | - Kate Misso
- Kleijnen Systematic Reviews Ltd, Unit 6, Escrick Business Park, Riccall Road, Escrick, York, YO19 6FD, UK
| | - Sohan Deshpande
- Kleijnen Systematic Reviews Ltd, Unit 6, Escrick Business Park, Riccall Road, Escrick, York, YO19 6FD, UK
| | - Jos Kleijnen
- Kleijnen Systematic Reviews Ltd, Unit 6, Escrick Business Park, Riccall Road, Escrick, York, YO19 6FD, UK
- Department of Family Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Ian Milsom
- Department of Obstetrics & Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
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Handelzalts JE, Yaakobi T, Levy S, Peled Y, Wiznitzer A, Krissi H. The impact of genital self-image on sexual function in women with pelvic floor disorders. Eur J Obstet Gynecol Reprod Biol 2017; 211:164-168. [PMID: 28279890 DOI: 10.1016/j.ejogrb.2017.02.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 02/23/2017] [Accepted: 02/27/2017] [Indexed: 01/20/2023]
Abstract
OBJECTIVE There is conflicting evidence regarding the impact of urinary incontinence and pelvic organ prolapse on overall sexual function. However, psychological variables thought to be associated with sexual function, have not been fully explored. We assessed the sexual functioning of women with pelvic floor disorders while measuring for psychological factors such as distress and genital self-image. STUDY DESIGN In a cross-sectional study, 155 women in an urogynecology outpatient clinic of a tertiary health center completed a demographic questionnaire, the Brief Symptom Index-18 (BSI-18), Pelvic Floor Distress Inventory-20 (PFDI-20), Genital Self-Image Scale-20 (GSIS-20) and the Female Sexual Function Index (FSFI). RESULTS Linear regression showed that when controlling for age and depression, GSIS significantly predicted FSFI total score (Beta=0.38, p<0.001) and the Desire subscale (Beta=0.55, p<0.001). Due to the low response rate in the GSIS and FSFI questionnaires, a preliminary analysis was conducted to characterize the responders. On univariate logistic regression, response to the GSIS was negatively correlated with age (OR=0.94, p=0.02) and being in a relationship (OR=2.3, p=0.016), yet the effect of being in a relationship was diminished in a multivariate model that included age. CONCLUSION The main variable associated with overall sexual function in women with pelvic floor disorders was low genital self-image. This variable is more important than self-reported symptoms, type of specific disorder or other demographic variables. Older women tended not to complete the scales concerning more intimate matters. We suggest that urogynecologists should inquire about genital self-image as well as sexual function in this population.
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Affiliation(s)
| | - Tal Yaakobi
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Israel
| | - Sigal Levy
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Israel
| | - Yoav Peled
- The Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Arnon Wiznitzer
- The Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Haim Krissi
- The Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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21
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Lindau ST, Abramsohn EM, Baron SR, Florendo J, Haefner HK, Jhingran A, Kennedy V, Krane MK, Kushner DM, McComb J, Merritt DF, Park JE, Siston A, Straub M, Streicher L. Physical examination of the female cancer patient with sexual concerns: What oncologists and patients should expect from consultation with a specialist. CA Cancer J Clin 2016; 66:241-63. [PMID: 26784536 PMCID: PMC4860140 DOI: 10.3322/caac.21337] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 11/13/2015] [Accepted: 11/18/2015] [Indexed: 12/15/2022] Open
Abstract
Answer questions and earn CME/CNE Sexual concerns are prevalent in women with cancer or cancer history and are a factor in patient decision making about cancer treatment and risk-reduction options. Physical examination of the female cancer patient with sexual concerns, regardless of the type or site of her cancer, is an essential and early component of a comprehensive evaluation and effective treatment plan. Specialized practices are emerging that focus specifically on evaluation and treatment of women with cancer and sexual function problems. As part of a specialized evaluation, oncologists and their patients should expect a thorough physical examination to identify or rule out physical causes of sexual problems or dysfunction. This review provides oncology professionals with a description of the physical examination of the female cancer patient with sexual function concerns. This description aims to inform anticipatory guidance for the patient and to assist in interpreting specialists' findings and recommendations. In centers or regions where specialized care is not yet available, this review can also be used by oncology practices to educate and support health care providers interested in expanding their practices to treat women with cancer and sexual function concerns. CA Cancer J Clin 2016;66:241-263. © 2016 American Cancer Society.
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Affiliation(s)
- Stacy Tessler Lindau
- Director, Program in Integrative Sexual Medicine for Women and Girls With Cancer, Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL
- Associate Professor, Department of Medicine-Geriatrics, University of Chicago, Chicago, IL
- MacLean Center on Clinical Medical Ethics, University of Chicago, Chicago, IL
- Associate Professor, Comprehensive Cancer Center, University of Chicago, Chicago, IL
| | - Emily M Abramsohn
- Researcher and Project Manager, Program in Integrative Sexual Medicine for Women and Girls With Cancer, Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL
| | - Shirley R Baron
- Assistant Professor, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Clinical Associate, Program in Integrative Sexual Medicine for Women and Girls With Cancer, Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL
| | - Judith Florendo
- Doctor of Physical Therapy, Florendo Physical Therapy, Chicago, IL
- Clinical Associate, Program in Integrative Sexual Medicine for Women and Girls with Cancer, Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL
| | - Hope K Haefner
- Professor, Department of Obstetrics and Gynecology, University of Michigan Health System, Ann Arbor, MI
| | - Anuja Jhingran
- Professor, Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Vanessa Kennedy
- Assistant Professor, Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California Davis Medical Center, Sacramento, CA
| | - Mukta K Krane
- Assistant Professor, Department of Surgery, University of Washington, Seattle, WA
| | - David M Kushner
- Director, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Jennifer McComb
- Assistant Clinical Professor, The Family Institute at Northwestern University, Evanston, IL
| | - Diane F Merritt
- Professor, Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, WA University School of Medicine, St. Louis, MO
| | - Julie E Park
- Associate Professor, Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Chicago, Chicago, IL
| | - Amy Siston
- Clinical Associate, Department of Psychiatry and Behavioral Neurosciences, University of Chicago, Chicago, IL
| | - Margaret Straub
- Physician's Assistant, Radiation Oncology, University of Wisconsin Carbone Cancer Center, University of Wisconsin, Madison, WI
| | - Lauren Streicher
- Associate Professor, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern Memorial Hospital, Chicago, IL
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Milsom I. Can we predict and prevent pelvic floor dysfunction? Int Urogynecol J 2015; 26:1719-23. [PMID: 26493692 DOI: 10.1007/s00192-015-2868-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 10/01/2015] [Indexed: 01/27/2023]
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Pelletier F, Girardin M, Humbert P, Puyraveau M, Aubin F, Parratte B. Long-term assessment of effectiveness and quality of life of OnabotulinumtoxinA injections in provoked vestibulodynia. J Eur Acad Dermatol Venereol 2015; 30:106-11. [PMID: 26491951 DOI: 10.1111/jdv.13437] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 07/27/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Provoked vestibulodynia is a relatively common condition that affects sexual activity. Multidisciplinary care is indicated and OnabotulinumtoxinA injections are safe and effective treatment in this indication. AIMS To assess the long-term efficacy of OnabotulinumtoxinA in provoked vestibulodynia. MATERIALS AND METHODS Twenty-one patients treated with OnabotulinumtoxinA injections (50U in each bulbospongiosus muscle) 24 months prior to the study were included. Data on pain [assessed using a visual analogue scale (VAS)], quality of life [measured by the Dermatology Life Quality Index (DLQI)] and quality of sex life [assessed using the Female Sexual Function Index (FSFI)] were collected before treatment, and 3 and 24 months after injection. RESULTS Nineteen patients participated in the study and 37% had no pain after 24 months. Significant improvements were noted in the VAS, DLQI and FSFI scores between baseline and 24 months post treatment (P < 0.0001). After 24 months, 18 patients (95%) were able to have sexual intercourse. This study was open and non-controlled. DISCUSSION AND CONCLUSION 100U OnabotulinumtoxinA injections constitute an effective treatment in provoked vestibulodynia with results maintained after 2 years. They significantly improve pain, and have a positive impact on patient quality of life and sex life. Beneficial effects continue in the long-term, allowing patients to resume sexual activity.
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Affiliation(s)
- F Pelletier
- Department of Dermatology, Besançon University Hospital, Besançon, France.,INSERM UMR1098, University of Franche-Comté, Besançon, France
| | - M Girardin
- Department of Dermatology, Besançon University Hospital, Besançon, France
| | - P Humbert
- Department of Dermatology, Besançon University Hospital, Besançon, France.,INSERM UMR1098, University of Franche-Comté, Besançon, France
| | - M Puyraveau
- Clinical Methodology Centre, Besançon University Hospital, Besançon, France
| | - F Aubin
- Department of Dermatology, Besançon University Hospital, Besançon, France.,University of Franche-Comté, Besançon, France
| | - B Parratte
- Department of Physical Medicine and Readaptation, Besançon University Hospital, Besançon, France.,Anatomy Laboratory, University of Franche-Comté, Besançon, France
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