[Effectiveness of early pelvic muscle training on pelvic floor strength, urinary incontinence symptoms, sexual function, and quality of life in post-radical prostatectomy patients: Systematic review of randomized clinical trials]

This study aimed to evaluate the effectiveness of early pelvic muscle training in reducing urinary incontinence symptoms, improving quality of life, sexual function, and increasing pelvic floor strength in post-radical prostatectomy patients. A search was carried out in 8 databases until October 26, 2022, the methodological quality and the risk of bias of 14 included studies (n=1236) were evaluated, moreover, the evidence and the meta-analysis were calculated. The intervention significantly reduced urinary incontinence symptoms compared to a control group (SMD=-2.80, 95% CI=-5.21 to -0.39, P=.02), with significant heterogeneity (I2=83%; P=<.0001) and moderate evidence. In addition, it presented moderate evidence to improve quality of life, and very low evidence to improve sexual function and pelvic floor strength. These results should be viewed with caution due to the significant heterogeneity of the studies analysed.

Measuring morphological parameters of the pelvic diaphragm muscles using computed tomography in healthy dogs

Evaluation of pelvic diaphragm muscles in dogs merits clinical attention because of the anatomical importance and their involvement in perineal hernia. This study aimed to evaluate the normal pelvic diaphragm muscles (levator ani and coccygeus muscles) using the computed tomography (CT) scan. For this purpose, 10 male and 10 female clinically normal, adult intact mixed-breed dogs weighing 15.00 to 20.00 kg were selected randomly. All animals underwent CT examination under general anesthesia and positioned in sternal recumbency. All the CT images were taken and reconstructed with a same protocol. The measurements of the pelvic diaphragm muscles were performed based on the presented guideline to the observer. The results were presented descriptively. The mean lengths of the coccygeus muscle in CT images were evaluated 4.60 cm for males and 4.30 cm for females. The mean lengths of levator ani muscle in CT images were measured 4.90 cm in males and 4.50 cm in females. In conclusion, the results of the present study can be beneficial to clinicians and researchers for further evaluation of the supporting muscles in pelvic cavity and underlying anatomical changes in perineal hernia in dogs.

[Rate of episiotomy in the University Clinical Hospital of Arrixaca and factors that influence in its practice.]

OBJECTIVE

The conduction of episiotomy is a questioned practice given the strong scientific evidence on its adverse effects. The study objectives were to know the episiotomy rate and its adaptation to the recommendations of the Ministry of Health, Consumption and Social Welfare and assess the associated factors.

METHODS

It has been made a Observational, descriptive and transversal quantitative study, it was carried out in the university clinical hospital arrixaca. Data were collected from deliveries attended between January 1, 2016 and October 30, 2017, obtaining a sample of 10,630 women, registered in the SELENE computer program which is the clinical database of said hospital. To perform the data analysis, were used the SPSS statistical program and an Excel database. At the first level, it was carried out a descriptive analysis of the obstetric variables and, at a second level, the data were compared with the Ministry of Health indicators by means of a comparison of two proportions and the chi-square test. In order to estimate the Effect Size, the Cramer V was used for qualitative variables and the relative risk was calculated for each pair of qualitative variablesas a relative measure of the effect, to determine the strength of association between the variables.

RESULTS

The episiotomy rate was 36.5%. When the birth started spontaneously, the percentage was 35.5%, when it was induced 47.2% and stimulated rate was 42.3%. The rate in eutocic deliveries was 20.6% and in instrumented was 95.25%. In primiparas, the episiotomy was 49.64% and in multiparas the conduction was 15.55%. Was observed a tendency of second-degree tears (43.40%), followed by first-degree (35.61%) and third-degree (19.81%) with episiotomy.

CONCLUSIONS

The episiotomy rate in our study exceeds current recommendations. The variables associated with the performance of the episiotomy are induced or stimulated delivery, instrumentation and primiparity. There is a significant relationship between the practice of episiotomy and the greater degree of tear.