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Pelvic floor injury

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https://www.readbyqxmd.com/read/29785548/operative-vaginal-delivery-in-case-of-persistent-occiput-posterior-position-after-manual-rotation-failure-a-6-month-follow-up-on-pelvic-floor-function
#1
Paul Guerby, Olivier Parant, Elodie Chantalat, Christophe Vayssiere, Fabien Vidal
PURPOSE: To compare the short- and long-term perineal consequences (at 6 months postpartum) and short-term neonatal consequences of instrumental rotation (IR) to those induced by assisted delivery (AD) in the occiput posterior (OP) position, in case of manual rotation failure. METHODS: A prospective observational cohort study; tertiary referral hospital including all women presenting with persistent OP position who delivered vaginally after manual rotation failure with attempted IR or AD in OP position from September 2015 to October 2016...
May 21, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29656330/risk-factors-for-anatomic-pelvic-organ-prolapse-at-6-weeks-postpartum-a-prospective-observational-study
#2
Cathrine Reimers, Franziska Siafarikas, Jette Stær-Jensen, Milada Cvancarova Småstuen, Kari Bø, Marie Ellström Engh
INTRODUCTION AND HYPOTHESIS: The objective was to identify risk factors for postpartum anatomic pelvic organ prolapse (aPOP) by comparing women with and without aPOP at 6 weeks postpartum with regard to pelvic floor measurements antepartum and obstetrical characteristics. METHODS: We carried out a prospective observational cohort study including nulliparous pregnant women in a Norwegian university hospital. Participants underwent clinical examinations, including pelvic organ prolapse quantification system (POP-Q) and transperineal ultrasound at gestational week 21 and at 6 weeks postpartum...
April 14, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29629963/health-care-seeking-characteristics-of-women-with-pelvic-floor-disorders-after-obstetric-anal-sphincter-injury
#3
Jon F Pennycuff, Deborah R Karp, Julia Shinnick, Catherine O Hudson, Gina M Northington
OBJECTIVES: Obstetric anal sphincter injury (OASIS) is a potentially serious complication of vaginal delivery and can lead to both short-term and long-term sequelae. This study sought to identify health care seeking patterns of women who developed pelvic floor symptoms including pelvic pain after OASIS. It also identified demographic and clinical factors associated with seeking subspecialty care from a pelvic floor specialist and demographic and clinical factors associated with seeking care for pelvic pain after OASIS...
April 6, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29609262/-multiple-factors-analysis-of-early-postpartum-pelvic-floor-muscles-injury-in-regenerated-parturients
#4
M Li, J Shi, Q P Lü, F H Wei, T Z Gai, Q Feng
Objective: To investigate the risk factors for multiparous pelvic floor muscles injury during 6-8 weeks after delivery. Method: From June 2015 to April 2017, 1917 women (1 523 primigravidas and 294 multiparas) were accepted postpartum pelvic floor function screening during 6-8 weeks after delivery in Beijing Hospital.Pelvic examination and pelvic floor muscle strength testing were carried out in these women.All the data were analyzed with multivariate logistic regression method to explore the related factors for postpartum pelvic floor muscle injury...
March 20, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29605709/intra-peri-and-postoperative-complications-in-pelvic-organ-prolapse-surgery-in-geriatric-women
#5
Marc Körnig, Esther Brühlmann, Andreas Günthert, Corina Christmann
OBJECTIVE: Pelvic organ prolapse is a common problem among geriatric women. Advanced age is associated with a high prevalence of comorbidities that can lead to restrictive use of surgical treatment. With rising life expectancy it is predicted that surgical treatment in these women will be seen more frequently. Inconsistently there is a lack of clinical trials giving attention to elderly women suffering from pelvic organ prolapse. The aim of this study was to quantify the rate of complications in elderly women undergoing surgery for pelvic organ prolapse...
May 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29574482/the-effect-of-pelvic-floor-muscle-training-and-intravaginal-electrical-stimulation-on-urinary-incontinence-in-women-with-incomplete-spinal-cord-injury-an-investigator-blinded-parallel-randomized-clinical-trial
#6
Marlene Elmelund, Fin Biering-Sørensen, Ulla Due, Niels Klarskov
INTRODUCTION AND HYPOTHESIS: Urinary incontinence is a prevalent problem in women with spinal cord injury. The aim of this study was to examine the effect of pelvic floor muscle training (PFMT) alone and combined with intravaginal electrical stimulation (IVES) on urinary incontinence in women with incomplete spinal cord injury. METHODS: In this investigator-blinded randomized clinical trial, we recruited women aged 18-75 with incomplete spinal cord injury and urinary incontinence from a single spinal cord injury clinic in Denmark...
March 24, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29564512/does-vaginal-delivery-cause-more-damage-to-the-pelvic-floor-than-cesarean-section-as-determined-by-3d-ultrasound-evaluation-a-systematic-review
#7
REVIEW
Camila Carvalho de Araujo, Suelene A Coelho, Paulo Stahlschmidt, Cassia R T Juliato
INTRODUCTION AND HYPOTHESIS: Pregnancy and delivery are well-established risk factors for pelvic floor dysfunction (PFD), but the physiopathology, such as the delivery route, is not well understood. This study evaluated the impact of delivery route on the pelvic floor muscles via 3D ultrasound. METHODS: This review is registered in the PROSPERO database. The criteria for inclusion were prospective studies with 3D translabial ultrasound assessment in primigravida women during pregnancy and postpartum published in English, Spanish or Portuguese between 1980 and 2016...
March 21, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29516128/is-increased-peripheral-ligamentous-laxity-in-term-pregnant-women-associated-with-obstetric-anal-sphincter-injury
#8
Bertrand Gachon, Marion Desgranges, Laetitia Fradet, Arnaud Decatoire, Florian Poireault, Fabrice Pierre, Xavier Fritel, David Desseauve
INTRODUCTION AND HYPOTHESIS: Increased ligamentous laxity is associated with pelvic floor distension in pregnant women. This considered, it may also be related to the risk of obstetric anal sphincter injury (OASI). Our objective was to assess the association among increased ligamentous laxity, perineal tear severity, and OASI occurrence. METHODS: This is a prospective study. We assessed ligamentous laxity between the 36th week of pregnancy and the onset of labor, by measuring the passive extension of the nondominant index finger for a 0...
March 7, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29500515/prevalence-and-predictors-of-double-incontinence-1-year-after-first-delivery
#9
Hege Hølmo Johannessen, Signe Nilssen Stafne, Ragnhild Sørum Falk, Arvid Stordahl, Arne Wibe, Siv Mørkved
INTRODUCTION AND HYPOTHESIS: Urinary (UI) and anal incontinence (AI) are common pelvic floor disorders (PFD), and postpartum women experiencing double incontinence (DI), the combination of UI and AI, tend to have more severe symptoms and a greater impact on quality of life. Our objective was to investigate the prevalence and predictors of postpartum DI and UI alone 1 year after first delivery. METHODS: In this prospective cohort study, 976 women reported the prevalence of DI and UI alone 1 year after their first delivery in one of two hospitals in Norway using the St Marks score and the ICI-Q UI SF...
March 2, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29498141/normal-values-for-assessment-of-anal-sphincter-morphology-anorectal-motion-and-pelvic-organ-prolapse-with-mri-in-healthy-women
#10
P Tirumanisetty, D Prichard, J G Fletcher, S Chakraborty, A R Zinsmeister, A E Bharucha
BACKGROUND: Endoanal MRI and MR defecography are used to identify anal sphincter injury and disordered defecation. However, few studies have evaluated findings in asymptomatic healthy people. The effects of BMI and parity on rectoanal motion and evacuation are unknown. METHODS: In 113 asymptomatic females (age 50 ± 17 years, Mean ± SD) without risk factors for anorectal trauma, anal sphincter appearance, anorectal motion, and pelvic organ prolapse were evaluated with MRI...
March 2, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29480430/could-the-correct-side-of-mediolateral-episiotomy-be-determined-according-to-anal-sphincter-emg
#11
Vita Začesta, Dace Rezeberga, Haralds Plaudis, Kristina Drusany-Staric, Corrado Cescon
INTRODUCTION AND HYPOTHESIS: Mediolateral episiotomy is one of the most frequent surgical interventions performed in obstetrics. There is conflicting evidence as to whether mediolateral episiotomy reduces the risk of obstetric anal sphincter injuries (OASI). Recent studies suggest that functional asymmetry of pelvic floor innervation exists in healthy women and is strongly associated with postpartum incontinence when the trauma occurs on the dominant side of innervation. Mediolateral episiotomy is the most common cause of perineal trauma during delivery, and the surgical incision is usually performed on the mediolateral right side...
February 26, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29474288/pelvic-floor-muscle-training-versus-watchful-waiting-and-pelvic-floor-disorders-in-postpartum-women-a-systematic-review-and-meta-analysis
#12
You Maria Wu, Natalia McInnes, Yvonne Leong
OBJECTIVES: Pelvic floor muscle training (PFMT) is often recommended to treat postpartum urinary incontinence (UI). However, the role of postpartum PFMT in pelvic organ prolapse (POP), sexual function, and anal incontinence (AI) remains unclear. We therefore aim to assess the efficacy of postpartum PFMT on these pelvic floor disorders. METHODS: This study is a meta-analysis consisting of randomized controlled trials (RCTs). We searched databases including CENTRAL, MEDLINE, EMBASE, CINAHL, and PEDro...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29474283/face-female-pelvic-medicine-and-reconstructive-surgery-awareness-campaign-increasing-exposure
#13
Susan A Barr, Catrina C Crisp, Amanda B White, Shazia A Malik, Kimberly Kenton
OBJECTIVE: The aims of this study are to identify screening, treatment, and referral practices of primary care physicians (PCPs) for patients with pelvic floor disorders (PFDs) and evaluate awareness of the Female Pelvic Medicine and Reconstructive Surgery (FPMRS) subspecialty. METHODS: We conducted a cross-sectional survey of PCPs using a random sample of 1005 American College of Physicians members, stratified by demographic region. Electronic survey content included awareness of FPMRS certification, comfort diagnosing and treating PFDs, and PFD referral patterns for PCPs...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29455045/impact-of-transvaginal-modified-sacrospinous-ligament-fixation-with-mesh-for-the-treatment-of-pelvic-organ-prolapse-before-and-after-studies
#14
Qinyi Zhu, Huimin Shu, Guiqiang Du, Zhiyuan Dai
BACKGROUND: Pelvic organ prolapse (POP) is a common disease in women. The aim of this research was to evaluate the safety, efficacy and complication of transvaginal modified sacrospinous ligament fixation with mesh using for the treatment of vaginal vault prolapse. MATERIALS AND METHODS: This was a prospective study including information from 60 symptomatic women with anterior-apical pelvic floor prolapse. The patients underwent transvaginal modified sacrospinous ligament fixation combined with anterior vaginal wall mesh between May 2014 and Sep 2015...
April 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29432755/pelvic-muscles-mechanical-response-to-strains-in-the-absence-and-presence-of-pregnancy-induced-adaptations-in-a-rat-model
#15
Tatiana Catanzarite, Shannon Bremner, Caitlin L Barlow, Laura Bou-Malham, Shawn O'Connor, Marianna Alperin
BACKGROUND: Maternal birth trauma to the pelvic floor muscles is thought to be consequent to mechanical demands placed on these muscles during fetal delivery that exceed muscle physiological limits. The above is consistent with studies of striated limb muscles that identify hyperelongation of sarcomeres, the functional muscle units, as the primary cause of mechanical muscle injury and resultant muscle dysfunction. However, pelvic floor muscles' mechanical response to strains have not been examined at a tissue level...
May 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29430972/the-behaviour-of-pelvic-floor-muscles-during-uterine-contractions-in-spontaneous-and-oxytocin-induced-labour
#16
Nazan Karahan, Hediye Arslan, Çetin Çam
Term pregnant women were divided into oxytocin infusion and control groups. The electrical activities of pelvic floor muscles (PFM) were recorded at rest and during contractions electromyographically. The beginning and the end of each contraction were marked on the recorded electromyographic trace. A trace was regarded as 'negative' if no increase in electrical activity was observed and 'positive' if increased electrical activity was observed during the contractions. To evaluate the relative frequency of the areas of electrical activity during uterine contractions (UC) a 'positive electrical activity percentage' was used and calculated as: (total count of positive electrical activity areas)/(total count of UC) × 100...
February 12, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29411072/prospective-evaluation-of-the-safety-and-feasibility-of-a-pelvic-floor-dilator-during-active-labor
#17
Francisco J Orejuela, Rajshi Gandhi, Lauren Mack, Wesley Lee, Haleh Sangi-Haghpeykar, Hans P Dietz, Susan M Ramin
INTRODUCTION AND HYPOTHESIS: The objective was to assess the safety and feasibility of using a pelvic floor dilator during active labor to prevent injuries to the levator ani muscle (LAM) and perineum. METHODS: In a prospective pilot study, a pelvic floor dilator using soft pads was introduced into the vaginal canal to gradually expand the vagina, in 30 nulliparous women and in 10 controls. The primary outcomes were adverse events related to the device. Secondary outcomes were perineal lacerations after delivery, sonographically defined levator ani injury, hiatal area dimensions, and anal sphincter disruption, all at 12-20 weeks postpartum, and maximum pelvic floor dilation, time to achieve maximum dilation, and device retention rate...
February 6, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29374994/uk-o-g-trainees-attitudes-to-caesarean-delivery-for-maternal-request
#18
Mehrnoosh Aref-Adib, Evangelia Vlachodimitropoulou, Rajvinder Khasriya, Benjamin W Lamb, Dan Selo-Ojeme
We assessed the attitudes of UK Obstetrics and Gynaecology (O&G) trainees towards a caesarean delivery for maternal request (CDMR); and identified differences in attitude towards patients requesting CDMR and preferences for their own mode of delivery. An internet survey was constructed with questions covering trainees' personal preferences towards and experience of CDMR; attitudes to CDMR; and how they might treat patients making this request. From 02/2013 to 06/2013, the survey was sent electronically via email to all UK Deaneries to be forwarded to O&G trainees...
April 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29241151/factors-that-influence-patient-preference-for-mode-of-delivery-following-an-obstetric-anal-sphincter-injury
#19
Emma Long, Swati Jha
PURPOSE: A common indication for elective caesarean is previous obstetric anal sphincter injury (OASI). This study aims to identify factors that influence womens' preferences regarding mode of delivery (MoD) in a subsequent pregnancy following an OASI. METHODS: 100 consecutive women who sustained an OASI completed a questionnaire when attending postnatal follow up at a perineal trauma clinic. They also completed ePAQ-PF to assess pelvic floor symptoms. Data was collated and percentages generated for each response...
February 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29169582/history-of-cervical-insufficiency-increases-the-risk-of-pelvic-organ-prolapse-and-stress-urinary-incontinence-in-parous-women
#20
David Sheyn, Kateena L Addae-Konaedu, Alison M Bauer, Konyinsola I Dawodu, David N Hackney, Sherif A El-Nashar
OBJECTIVE: A likely contributor to pelvic floor disorders is injury and degradation of connective tissue components such as collagen and elastin, leading to weakening of the pelvic floor. Prior studies have found similar connective tissue component changes in women with cervical insufficiency (CI). However, the connection between pelvic floor disorders and cervical insufficiency has not previously been evaluated. Our objective was to determine whether a history of cervical insufficiency is associated with an increased risk of pelvic organ prolapse and stress urinary incontinence after controlling for confounders...
January 2018: Maturitas
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