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Pelvic floor disorders

R M Islam, R J Bell, B Billah, M B Hossain, S R Davis
OBJECTIVE: To investigate the prevalence of, and risk factors for, pelvic floor disorders (PFDs) in women in Bangladesh. METHODS: A nationally representative sample of 1590 Bangladeshi women, aged 30-59 years, was recruited using a multistage cluster sampling technique, between September 2013 and March 2014. Urinary incontinence (UI), fecal incontinence (FI) and pelvic organ prolapse (POP) were assessed using validated questionnaires. The weighted prevalence and the factors associated with each PFD were investigated using multivariable weighted logistic regression...
October 20, 2016: Climacteric: the Journal of the International Menopause Society
Marian Wiegersma, Chantal M C R Panman, Marjolein Y Berger, Henrica C W De Vet, Boudewijn J Kollen, Janny H Dekker
BACKGROUND: The Pelvic Floor Distress Inventory-20 is used to evaluate symptoms and treatment effects in women with pelvic floor disorders. To interpret changes in the scores of this inventory, information is needed on what patients and clinicians perceive as the minimal important (meaningful) change. Although this change in the inventory score has previously been investigated in women undergoing pelvic floor surgery, the results could not be generalized to women with milder symptoms (i...
October 14, 2016: American Journal of Obstetrics and Gynecology
Jwan Al-Mukhtar Othman, Sigvard Åkervall, Ian Milsom, Maria Gyhagen
BACKGROUND: A systematic survey of pelvic floor disorders in nulliparous women has not been presented previously. OBJECTIVE: The purpose of this study was to determine the prevalence of urinary incontinence parameters in a large cohort of non-pregnant, nulliparous women, and thereby construct a reference group for comparisons with parous women. STUDY DESIGN: This postal and web-based questionnaire survey was conducted in 2014. The study population was identified from the Total Population Register in Sweden and comprised women who had not given birth and were aged 25-64 years...
October 6, 2016: American Journal of Obstetrics and Gynecology
Adil E Bharucha, Tae Hee Lee
Although pelvic pain is a symptom of several structural anorectal and pelvic disorders (eg, anal fissure, endometriosis, and pelvic inflammatory disease), this comprehensive review will focus on the 3 most common nonstructural, or functional, disorders associated with pelvic pain: functional anorectal pain (ie, levator ani syndrome, unspecified anorectal pain, and proctalgia fugax), interstitial cystitis/bladder pain syndrome, and chronic prostatitis/chronic pelvic pain syndrome. The first 2 conditions occur in both sexes, while the latter occurs only in men...
October 2016: Mayo Clinic Proceedings
Mark S Cook, Laura Bou-Malham, Mary C Esparza, Marianna Alperin
INTRODUCTION AND HYPOTHESIS: Pelvic floor muscle rehabilitation is a widely utilized, but often challenging therapy for pelvic floor disorders, which are prevalent in older women. Regimens involving the use of appendicular muscles, such as the obturator internus (OI), have been developed for strengthening of the levator ani muscle (LAM). However, changes that lead to potential dysfunction of these alternative targets in older women are not well known. We hypothesized that aging negatively impacts OI architecture, the main determinant of muscle function, and intramuscular extracellular matrix (ECM), paralleling age-related alterations in LAM...
October 4, 2016: International Urogynecology Journal
Jeannine Marie Miranne, Robert Eric Gutman, Andrew Ian Sokol, Amy Josephine Park, Cheryl Bernadette Iglesia
OBJECTIVE: To determine whether use of a new personalized risk calculator increases patient satisfaction with the decision whether or not to have a prophylactic midurethral sling (MUS) during pelvic organ prolapse (POP) surgery. METHODS: We performed a randomized controlled trial involving English-speaking women without symptoms of stress urinary incontinence (SUI) with ≥ stage 2 POP who planned to undergo POP surgery with 1 of 4 fellowship-trained urogynecologists at a single academic center...
September 26, 2016: Female Pelvic Medicine & Reconstructive Surgery
Suzanne N Landi, Kemi M Doll, Jeannette T Bensen, Laura Hendrix, Carey K Anders, Jennifer M Wu, Hazel B Nichols
PURPOSE: Endocrine therapy for breast cancer can exacerbate menopausal symptoms. The association between endocrine therapy and common pelvic floor disorders including urinary incontinence has rarely been evaluated. We examined urogenital and sexual side effects among women with a breast cancer diagnosis, comparing endocrine therapy users to nonusers. METHODS: Urogenital and sexual symptoms were self-reported during the enrollment interview within the University of North Carolina Cancer Survivorship Cohort...
September 28, 2016: Cancer Causes & Control: CCC
Ahmed Al-Badr, Rafeef Al-Juraifani, Ghadeer Al-Sheikh, Hazem Al-Mandeel, Lateefa Al-Dakhyel, Nadeen Al-Shahrani
INTRODUCTION AND HYPOTHESIS: A valid and reliable Arabic version of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, IUGA-revised (PISQ-IR) is needed. METHODS: Of 238 Saudi Arabian women who fulfilled the inclusion criteria, 227 were recruited. A detailed history was obtained and pelvic examination was performed in all participants. An Arabic version of the PISQ-IR was administered with three quality of life measures. Reliability was assessed by factor analysis, and internal consistency was measured with Cronbach's α...
September 27, 2016: International Urogynecology Journal
Baharak Amir, Victoria M Allen, Susan Kirkland, Kathleen MacPherson, Scott Farrell
OBJECTIVE: To estimate the influence of labour and pregnancy factors on long-term pelvic floor health outcomes. METHODS: This population-based cohort study was conducted using linkage between the Nova Scotia Atlee Perinatal Database, the Medical Services Insurance Database, and the Canadian Institute for Health Information's Discharge Abstract Database from 1988 to 2006; this allowed for the evaluation of patient utilization of care providers for pelvic floor disorders and captured conservative and surgical interventions...
September 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Gena C Dunivan, Katherine E Lyons, Peter C Jeppson, Cara S Ninivaggio, Yuko M Komesu, Frances M Alba, Rebecca G Rogers
OBJECTIVES: This study aimed to describe the relationship between genital hiatus (GH) and perineal body (PB) measurements with increasing pelvic organ prolapse (POP) stage in a large cohort of women referred to Urogynecology clinic for pelvic floor disorders. METHODS: Retrospective chart review of all new patients seen in an academic Urogynecology clinic between January 2007 and September 2011 was performed. Data were extracted from a standardized intake form. All patients underwent a Pelvic Organ Prolapse Quantification (POPQ) examination...
September 21, 2016: Female Pelvic Medicine & Reconstructive Surgery
Andrea Braga, Marco Soligo, Maurizio Serati, Giovanni Palleschi, Vincenzo Li Marzi, Enrico Finazzi Agrò
INTRODUCTION: Pelvic floor disorders (PFDs), which include urinary incontinence, pelvic organ prolapse, sexual dysfunction and gastrointestinal disorders, affect over 20% of adult population. The prevalence and demand for care of PFDs appear to be increasing more quickly than would be expected from simple population growth, creating substantial physical and emotional distress and a large financial burden. Suitable diagnostic tools are necessary to investigate these problems. The aim of this article is to list Symptom and Quality of Life questionnaires [briefly identified as patient-reported outcomes (PROs)] formally validated into the Italian language to provide Italian clinicians and researchers a tool for the assessment of pelvic area dysfunctions in our country...
September 26, 2016: Urologia
Khelifa Ait Said, Yannick Leroux, Benjamin Menahem, Arnaud Doerfler, Arnaud Alves, Xavier Tillou
BACKGROUND: Few studies have established that obesity promotes all types of urinary incontinence and disorders of the pelvic floor. The role of bariatric surgery in urinary incontinence remains poorly studied. OBJECTIVE: To determine the effect of bariatric surgery on urinary incontinence, dysuria, and fecal incontinence before and 1 year after bariatric surgery. SETTING: University hospital expert in bariatric surgery METHODS: This was an observational cohort study of 140 patients who underwent bariatric surgery between September 2013 and September 2014...
August 18, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Jan J van Iersel, Chris J de Witte, Paul M Verheijen, Ivo A M J Broeders, Egbert Lenters, Esther C J Consten, Steven E Schraffordt Koops
BACKGROUND: Pelvic floor disorders are a major public health issue. For female genital prolapse, sacrocolpopexy is the gold standard. Laparoscopic ventral mesh rectopexy is a relatively new and promising technique correcting rectal prolapse. There is no literature combining the 2 robotically assisted techniques. OBJECTIVE: This study was designed to evaluate the safety, quality of life, and functional and sexual outcomes of robot-assisted sacrocolporectopexy for multicompartment prolapse of the pelvic floor...
October 2016: Diseases of the Colon and Rectum
Kelly M Scott, Lauren W Fisher, Ira H Bernstein, Michelle H Bradley
BACKGROUND: Coccydynia is a challenging disorder that often is refractory to treatments such as medications and injections. Physical therapy for coccydynia rarely has been studied. OBJECTIVE: To evaluate the efficacy of pelvic floor physical therapy for reducing pain levels in patients with coccydynia. DESIGN: Retrospective chart review. SETTING: The pelvic floor rehabilitation clinic of a major university hospital. PATIENTS: A total of 124 consecutive patients over age 18 with a chief complaint of coccydynia between 2009 and 2012...
August 24, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Xiani Yan, Jennifer A Kruger, Xinshan Li, Poul M F Nielsen, Martyn P Nash
Vaginal delivery is the primary cause of levator ani muscle injury, which is in turn the leading factor contributing to pelvic floor disorders including pelvic organ prolapse and urinary stress incontinence. Existing biomechanical models of childbirth have provided some understanding of pelvic floor function during delivery and have helped in the investigation of preventative strategies. The modeling frameworks for childbirth simulation are described with emphasis on (1) the recent advances in medical imaging quality and computational power; (2) improvements in the anatomical representation of the pelvic floor and fetal head; (3) more realistic boundary conditions for delivery; and (4) mechanical properties determined from experiments...
November 2016: Wiley Interdisciplinary Reviews. Systems Biology and Medicine
Moez Kdous, Jad Diari, Monia Ferchiou, Fethi Zhioua
AIM: To evaluate the anatomical and functional outcomes of laparoscopic sacrocolpopexy using an anterior and a posterior prolen mesh, for the cure of genital prolapse. STUDY METHODS: This is a consecutive five year prospective observational study in which 80 patients presented with at least a Stage 2 apical prolapsed (Baden and Walker), with an anterior or a posterior vaginal wall prolapse, who underwent a double sacrocolpopexy. Two prolen prosthesis (Pro-swing® - Textile Hi-Tec™, Fr) were used for this technique...
February 2016: La Tunisie Médicale
Yechiel Z Burke, Lior Lowenstein
INTRODUCTION: Female sexual dysfunction (FSD) is multifactorial, with psychological and organic elements. Genital sensation, an important component of sexual response, has until recently not been subjected to adequate clinical appraisal. During the past 15 years we have performed Quantitative Sensory Testing (QST) to assess genital sensation in healthy women and women with FSD. AIM: To review available evidence of QST in the investigation of genital sensation in women with FSD...
April 2016: Sexual Medicine Reviews
Denise Howard, Michel Makhlouf
INTRODUCTION AND HYPOTHESIS: Significant breakthroughs in our understanding of pelvic floor dysfunction have occurred in the past two decades. The next step is to translate this understanding into effective preventative and early intervention strategies to minimize maternal morbidity from vaginal birth. We have learned enough to chart a course toward prevention. METHODS: This article outlines some major advances in understanding the pathophysiology of pelvic floor dysfunction and suggests strategies for future prevention research...
August 15, 2016: International Urogynecology Journal
Ashley Cannon, Svetlana Kurklinsky, Kimberly J Guthrie, Douglas L Riegert-Johnson
UNLABELLED: Objective. To describe the use of an advanced genetic testing technique, whole exome sequencing, to diagnose a patient and their family with a SCN9A channelopathy. Setting. Academic tertiary care center. Design. CASE REPORT: Case Report. A 61-year-old female with a history of acute facial pain, chronic pain, fibromyalgia, and constipation was found to have a gain of function SCN9A mutation by whole exome sequencing. This mutation resulted in an SCN9A channelopathy that is most consistent with a diagnosis of paroxysmal extreme pain disorder...
2016: Case Reports in Neurological Medicine
J T Y Franco, A M Agulhon, F C Viani, R G Viebig
CONTEXT: Faecal incontinence is defined as the involuntary loss of intestinal contents (whether faeces or gas). Although it is not frequently reported, it does cause physical and psychological distress. Traditional Chinese medicine believes that the healthy human body is originally in a state of balanced energy (Qi) between Yin and Yang, and all disorders that occur in the body are explained by disruptions in this energy balance. Acupuncture is a valuable therapy and is used as a therapeutic approach for the treatment of pelvic floor dysfunction...
August 2016: Complementary Therapies in Clinical Practice
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